天美传媒

Remote patient management enables patients to monitor their conditions in their own homes and share the results with their doctors via mobile devices.

Health-care systems around the world share the so-called "triple aim" of improving patients' experience of care, improving the health of increasingly older populations, and reducing costs per capita. Remote patient management (RPM) would appear to serve these objectives. So why has there been a delay in the adoption of such tools?

A by Jaume Ribera and Elena Reutskaya, conducted on behalf of the 天美传媒/Accenture Center for Research in Health-Care Innovation Management in collaboration with Telef贸nica, aimed to address this question through surveys and focus groups of health-care professionals and patients.

RPM enables people with chronic conditions, such as diabetes, high blood pressure, heart disease or respiratory ailments, to monitor their conditions in their own homes, and then share the results with their doctors in real time via mobile devices.

Previous RPM trials in the United Kingdom, the United States and Spain have found that proper usage of RPM led to reductions of between 14 and 20 percent in ER visits and admissions, bed stays and mortality costs.

As such, the majority of health-care professionals and patients tend to view RPM positively, with the survey respondents believing it can improve the quality of care while also empowering patients to manage their own conditions better.

Health-care professionals, in particular, were enthusiastic about the efficiency gains for the system and reductions in overcrowded hospitals.

Discrepancies between practitioners & patients

However, the authors found some distinct differences between health-care professionals and patients in how they regarded RPM.

Although health-care professionals believed that only a third of their patients would be willing to use RPM to manage their conditions, 70 percent of patients said they would consider using it. Patients with heart disease and chronic obstructive pulmonary disease (COPD) seemed to view RPM slightly more positively than the rest.

That said, patients did express a number of concerns, the most important being the fear of losing personal contact with their medical professionals. Most said they would feel comfortable having consultations with their doctor via videoconferencing, though more than half of health-care professionals said they would not feel comfortable using videoconferencing with patients.

As with health-care professionals, patients believed that lack of access to, knowledge of and confidence with technology could be the biggest potential barrier for using RPM. They were also concerned about cost and privacy issues.

Key recommendations

Based on what health-care professionals and patients told them, the authors make several recommendations to maximize the potential of RPM.

• Enhance Information Provision. Although many have heard of RPM, few understand what it entails. The first step to promote the successful adoption of RPM is to explain exactly what it means.
• Make Findings Widely Available. Health authorities should be gathering the findings on RPM initiatives and making the results widely available to professionals, patients and policymakers.
• Spread Awareness. Pay special attention to those groups with the least knowledge about RPM.
• Target Enthusiastic Patients. Those who have already benefited from such programs can serve as excellent champions or ambassadors for RPM.
• Get the Private Sector On Board. The private sector seems less aware and less open to using RPM compared with the public sector. Information on insurance payments and privacy needs to be conveyed to private practitioners.
• Make It Credible. To build confidence, information about RPM must come from reliable sources, such as medical professionals or health officials.
• Reassure Patients. Make it clear that RPM is a complement to, not a replacement for, visits to the doctor.
• Give Adequate Support. Many patients do not have the technology, knowledge or confidence to use RPM systems. People who are less IT literate should be given necessary support, and the systems should have various levels of sophistication.
• Protect Privacy. The privacy and integrity of medical records must be protected at all times.

The study indicates that health-care professionals, and especially patients, perceived RPM to be something they could use, provided that they were informed by a reliable source; that RPM was used as a complement to, not a substitute for, doctor's visits; and that security systems guaranteed the privacy of their information.