Six months ago, I implanted a small device in the heart of Margaret McDermott of Birmingham, a 71-year-old woman with heart failure. She had recently been hospitalized for pulmonary edema (fluid in the lungs). She was selected to participate in an exclusive study, where a tiny microcomputer would be implanted in her heart. This microcomputer can transmit accurate heart pressure readings remotely. Until now, this information was available only in hospitals.
I knew that having this information remotely would allow me to intervene early enough before she had symptoms and adjusted her medications. But I had not appreciated the full value of this technology until the beginning of the COVID-19 outbreak, Margaret was unable to go to the hospital and I was forced to rely heavily on remote readings from the device. Just a few days ago, I noticed that Margaret's heart pressure had increased to levels that could cause pulmonary edema. I called her and recommended an increase in the dose of water pills (furosemide). For ten days, the pressure decreased to levels that do not lead to pulmonary edema. Because of this small device, she got the best possible care without having to go to the hospital and expose herself to the risks of COVID-19.
75% drop in hospitalizations
Remote monitoring of patients has many values in general, but an even greater value for people suffering from chronic diseases. According Statista Research Department, the remote patient monitoring market in the US in 2015 was valued at about $ 175 million (€ 159 million) and is expected to grow to almost $ 536 million (€ 486 million) by 2022. Now, with the COVID pandemic -19, remote control and market monitoring is likely to increase further.
At normal times, remote patient monitoring keeps the patient under supervision, regardless of location, time restrictions, availability of hospital facilities and availability of the caregiver. Patient convenience is always an important consideration, but when it comes to the elderly population who may have difficulty moving, remote care is an absolute change. In addition, remote patient monitoring reduces the burden on healthcare systems. It allows you to get treatment well in advance and, as a result, reduces hospitalizations and readmissions, which places a huge burden on health systems worldwide.
According to a Deloitte Center for Health Solutions survey, remote patient monitoring is expected to save $ 200 billion (€ 181 billion) in healthcare costs globally over the next 25 years. The remote service sector is seeing positive trends; The Roanoke-Chowan Community Health Center reports that hospital readmissions drop by 75% for chronic patients using a remote patient monitoring system.
In times of restricted movement, such as we are today, remote monitoring of patients can free up valuable healthcare professionals and equipment so they can focus on combating pandemics. Margaret's case shows how, during a pandemic blockade, medical staff can continue to monitor and maintain high-risk chronic patients at home, ensuring that they receive the high-quality care they need.
The development of remote service technologies is on the rise
The market for implantable and portable devices that monitor vital body parameters, such as body temperature, blood pressure, heart rate and saturation, is growing rapidly. Some of them are focused on health conscious, like the Apple Watch, while others are targeted at high-risk patients, like Vector V-LAP, the device installed in Margaret's heart. This microcomputer in the heart is a digital wireless device, located in the left atrium of the heart and daily monitors heart failure patients.
Other interesting remote monitoring devices that can collect robust data include the Owlytics smartwatch, which was designed to continuously and automatically detect falls in the elderly population, Neoteryx Mitra Microsampling Devices, were used to simplify blood collection for patients at home and DexCom, which allows continuous monitoring of glucose in people with diabetes, so they do not need to prick their fingers to perform the test
A company called TytoCare bridged some of the gaps between online contactless testing and physical examination. The system instructs the patient how to perform the test and can identify whether the test was performed correctly and whether the doctor has the necessary information. This system is much cheaper than a personal meeting with a doctor and eliminates the need for frequent visits.
It's time to change
The COVID-19 pandemic is forcing us to change our usual care practices and to rely on remote patient monitoring. Even when the COVID-19 crisis ends, this change is likely to be based on routine clinical practice. It is time to adopt more widely remote patient monitoring and treatment technologies. What was previously considered a luxury in the health system, must now be implemented as a standard of care.
- Professor Francisco Leyva-Leon is a cardiologist at Queen Elizabeth Hospital in Birmingham, UK.
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