Three Challenges to Remote Patient Monitoring

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By Jiang Li, CEO of VivaLNK

After undergoing successful surgery at a hospital, a patient is discharged. Then within 30 days, they are readmitted. This sequence of events occurs over 20 percent of the time – frustrating patients, doctors and hospitals, and costing the industry billions of dollars each year. Patient care is heavily skewed towards in-hospital situations, but virtually nonexistent when remote.

Remote Patient Monitoring (RPM), a rapidly growing healthcare segment, can be the key to driving down readmission rates as well as making medicine more cost-effective and accessible for the masses. A key component of RPM is wearable devices that allow medical professionals to monitor and diagnose patients without ever seeing them in the office. These devices have the ability to remotely monitor patient vitals as well as other symptoms, which can then be used as indicators of impending medical issues.

One example of RPM devices are the latest FDA-cleared continuous temperature monitors that aid in the early detection of infections. A study from The BMJ notes infection is one of the leading causes of avoidable readmission into the hospital, which can be painful for the patient and expensive for both the patient and the hospital. These devices are worn by the patient at home, and transmit medically accurate data to a doctor or nurse at another location.



However, RPM is challenging because you remove the support of medical staff to ensure proper usage. Situations where it is the patient’s responsibility to adhere to any component of a treatment plan introduces challenges with patient compliance. RPM is no different. In order for RPM devices to be successful, three things need to happen: 1) wearability, 2) data accuracy, and 3) data access.

Achieving Comfort and Usability

Wearability is not only the most subjective issue, but perhaps the biggest issue to RPM device adoption, especially in longer term or continuous applications. Simply put, if the patient doesn’t wear it, it won’t work. Wearability has to do with comfort and convenience.  A comfortable device that is difficult to operate will not succeed. Conversely, a simple device that is uncomfortable to wear will fail.

Today, if you need to be diagnosed for certain types of arrhythmia, you may be prescribed a bulky monitor to wear for a couple of days to track your heart rhythm. This gives doctors a snapshot of your condition, but may not capture all the data they need. If doctors were able to see patterns over an extended period of time, more rapid and accurate diagnosis can be performed. With a new class of continuous cardiac monitors such as wearable patches, data can be tracked 24-hours a day over extended periods of time.

Form Factor and Sensor Upgrades to Improve Data Accuracy

Data accuracy is the next important factor in RPM devices. The devices field is crowded with consumer style wearables, and some FDA-cleared medical devices. The challenge has been the convergence of the two into a form factor that offers wearability and medical accuracy. Consumer style wearables are user friendly, but often lack the accuracy and validation for medical use. Not only may the sensors and technologies in consumer wearables be lacking, but the position on the body, such as the wrist, can limit data accuracy. On the other hand, medical devices fall short on user friendliness. However, recently we’ve seen examples of such converged devices in FDA-cleared continuous fever monitors and mobile ECG recorders.

Connecting Patient Data to Providers

The final piece for RPM’s fullest potential is  timely access to data. In the case of infection monitoring, time is of the essence. Or if a patient is being treated for heart conditions, it is important to know as soon as certain problem indicators are happening. A key challenge with data access is network availability. Not all consumers have a home network, but with the prevalence of mobile phones, network connectivity has become pervasive. It has become the most common solution to providing “real-time” access to the data on wearable devices.

However, the mobile phone solution is not without its challenges. A personal device can vary greatly from person-to-person, thus reducing the overall dependability of the solution (e.g. compatibility, storage space, performance). The industry is taking steps to alleviate the network problem. Some are providing patients with a provisioned phone. Others are optimizing data management to limit the traffic volume, and still others are looking into specialized network devices for managing and transmitting healthcare data.

The ability for doctors to monitor key indicators of disease remotely could not only bring down costs and the number of unnecessary visits, but drastically improve preventative, proactive care. Telemedicine and remote patient monitoring are essential to a future where we are focused on precision health, not only precision medicine. With medical-grade wearables, doctors will have broader and deeper insights into your health, not only for diagnosis and treatment, but also prevention. In the near future, a doctor’s visit may happen completely from the comfort of your home.

Jiang Li, founder and CEO of VivaLNK, has both passion and extensive experience in bringing innovative technology and products into the marketplace, including the world’s first electronic skin technology called eSkin Tattoo in partnership with Google. Prior to joining VivaLNK, he was responsible for new product and technology development as the VP of engineering in Kovio and Thinfilm Electronics, leading printed electronics companies. Prior to that, he worked at AMD and the joint venture between AMD/Fujitsu, Spansion. As the VP of product engineering in Spansion, Jiang managed the major new product launches in Spansion. Jiang holds a Ph.D. degree from the University of Wisconsin-Madison, and a bachelor’s degree from Zhejiang University in China.

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