The use of patient monitoring has surged during COVID-19. Here’s what health providers should know about patient monitoring during a pandemic, and beyond.
The COVID-19 pandemic has shifted the way care is delivered on a fundamental level. What was once an up-and-coming tool for improved care delivery — namely, advanced patient monitoring technology — is now at the forefront of virtually every aspect of patient care. And, although this dramatic shift has occurred over the space of a few months, the consensus is that it’s also here to stay.
Of course, the use of patient monitoring had been already growing in the years before the pandemic. Yet adoption of those technologies — specifically, remote patient monitoring (RPM) and contact-free continuous monitoring (CFCM) — was far from universal, despite the extensively documented benefits of each. With its need for remote, less-intrusive care, COVID-19 has changed all of that.
So, given the urgent need, what should providers know before committing to a patient monitoring system? Let’s start at the beginning. Both RPM and CFCM are based on a central idea: monitoring and assessing vital information from patients on a continuous basis, with as little physical contact as possible, for the purpose of early intervention, cost containment and more effective overall care.
Within that broad description, though, there’s quite a bit of room for variation. For instance:
- How well, and how quickly, is data being processed?
- Are patients comfortable with the system?
- Is critical information being delivered in a way that’s easily accessible to caregivers, while avoiding negative triggers like alarm fatigue or information overload?
Thanks to decades of prior use, experts have had the chance to develop best practices around these tools, and can offer solutions to these and other aspects of implementing RPM and CFCM systems. As such, here are 5 key factors that providers should consider before committing to a patient monitoring technology, during the pandemic and beyond.
5 Key Considerations for Patient Monitoring during a Pandemic
#1: Leverage contact-free monitoring and communication to halt the spread of infection.
Long an emerging aspect of everyday care, remote patient monitoring (RPM) has surged to the forefront of essential clinical technologies because of COVID-19. The urgent need for everyone to isolate as much as possible has driven the almost universal adoption of virtual visits, or video-based interactions between patients and their doctors or caregivers, as well as among clinical staff.
RPM extends this virtual aspect of care by giving providers the ability to monitor a patient’s condition from another location. By providing frequent updates on a patient’s biometric statistics and changes to key metrics, RPM lets patients with chronic conditions be treated at home, instead of taking up a facility bed that they may not need — a helpful tool in limiting potential COVID-19 exposure points.
Within facilities, CFCM is also being increasingly used to help reduce the risk of contamination by enabling isolation rooms and general distancing. A technology that monitors vital signs (like heart and respiratory rate) from an unobtrusive location beneath the patient’s mattress, CFCM gives providers the option to keep careful watch over their patients without the need to enter the room or visit a bedside.
So effective has CFCM shown itself to be for limiting patient contact that Tel Aviv’s Sheba Medical Center has used it to monitor COVID-19 patients from the Diamond Princess cruise ship upon their arrival in Israel. The system used “collects and analyzes more data than traditional methods, and is not invasive,” as Sara Toth Stub describes the process at U.S. News & World Report.
Thanks to this use of CFCM, along with a handheld mHealth (i.e., mobile health) device for COVID-19 patients in their care, Sheba Medical Center team has been able to meet all the medical needs required by the situation without exposing its staff to undue risk. The makers of that CFCM technology, EarlySense, told CTech in May that there have been no cases of medical staff contracting the virus in departments that use it.*
#2: Keep caregivers better informed with better, more easily accessed information.
Access to instant changes in a patient’s condition is a powerful benefit of implementing RPM and CFCM. That kind of actionable data, continuously delivered, can improve outcomes and response rates. This has been documented in a number of case studies, including one showing that CFCM “alerted staff regarding an abnormal respiratory rate” that resulted in a potentially life-saving emergency transferal.*
To that end, leading patient monitoring technologies are designed to provide not just an important view into a patient’s health at any given time, but also a means to instantly alert caregivers if any aberration is detected. Those alerts, and other crucial info, should be available not just on a central display at the relevant nursing station, but also on personal devices carried by caregivers, when possible.
But no matter how important their message is, alerts aren’t effective if they’re not integrated into a clinician’s routine in a smart, unobtrusive and helpful manner. Alerts and notifications should be designed to minimize the alarm fatigue that caregivers can experience under the best of times, and which are only exacerbated during the high-stress conditions imposed on many facilities by COVID-19.
#3: Engage patients as much as possible, whenever possible.
When caring for quarantined patients from the Diamond Princess, the team at Sheba Medical Center offered, along with contact-free continuous monitoring, the use of “hand-held smart devices.” These devices gave doctors additional insights into patient heart and lung activity, and actual snapshots of the ears and throats, to better detect the respiratory issues connected with COVID-19.
This integration of mHealth (i.e., mobile health) devices can be a powerful catalyst to the success of patient monitoring, since it encourages active participation with doctors and clinicians in a patient’s own wellbeing. The resulting engagement can be “key in getting people who may not even be sick to comply with precautionary medical monitoring,” as the U.S. News report points out.
In a conversation with Medical Economics on making the shift to virtual care, Reliance Medical Group President and CEO Dr. Jon Regis makes a similar point. “I think the key is being able to monitor the patient, give the patient better access, get the patient better engagement using a technology — I call them ‘gizmos’ sometimes — to make sure they were in better contact,” he said.
Courting patient engagement via handheld devices is also in keeping with the surging popularity of mHealth, or mobile health, devices in general. This was true well before the COVID-19 pandemic forced many folks to pursue health info on their phones rather than their regularly planned sit-down with the family doctor, with some 97,000 health and fitness apps available in 2019.
For this reason, most RPM devices have a built-in mobile component designed to “nudge” patients to participate and engage. For CFCM, that engagement comes via the device’s non-invasiveness, and the peace of mind knowing that their health is under constant monitoring, every minute of the day.
#4: Make full use of today’s advanced clinical intelligence gathering and analytical tools.
Many facilities are enlarging their patient monitoring capabilities out of sheer necessity because of the pandemic. Yet unexpected as the change may be, it still provides a key opportunity to better make use of the clinical intelligence, which has advanced by leaps and bounds in recent years toward the goal of achieving value-based care and improving overall outcomes and operational efficiencies.
In other words, integrating patient monitoring technologies can help meet not just the immediate needs of COVID-19 patient management, but also other long-term clinical goals related to population health management. This is possible by not just collecting data but also applying “machine-learning and artificial intelligence to analyze the data,” as Sheba Medical Center’s Dr. Eyal Zimlichman told U.S. News.
It’s also important to choose a CFCM or RPM system that makes the best use of the immense amounts of patient data it gathers. The idea is to give clinicians the most pertinent info with as little effort as possible. While they’re focusing on patient care, advanced analytical tools are processing the data generated from patient monitoring to provide the essential big-picture info or urgent health alerts.
#5: Approach patient monitoring with a long-term mentality.
Whether or not the implementation of new patient monitoring tools is part of a system-wide overhaul or simply another powerful option in your suite of care tools, the smart choice is to treat them not as a temporary solution but as permanent feature. With their capacity to improve outcomes and patient satisfaction, RPM and CFCM make helpful additions to any long-term care strategy.
Certainly, the Centers for Medicare & Medicaid Services (CMS), the nation’s largest insurer, is thinking along these lines, having recently expanded its 2021 reimbursement proposal to include more allowances for RPM. And in an era when many nursing facilities have yet to embrace patient monitoring, the use of these solutions could provide a key competitive advantage in the years to come.
With that in mind, many experts advise looking at patient monitoring as a fixed infrastructural improvement. “I think that the changes you’re going to see in healthcare are going to last forever, and some of the changes are going to be good,” as Dr. Regis said.
Others agree. Sharing the belief that the current shift to remote care “is permanent,” former Mayo Clinic CEO and current head of OptumHealth Dr. Wyatt Decker has predicted “a wave of ongoing adoption and increased acceptance, even as the pandemic begins to wind down.”
The bottom line? Even before COVID-19, healthcare was in a state of uncertainty. At a time when that uncertainty has only increased, the smart, long-term use of patient monitoring technologies could provide the rare opportunity to leverage available, cost-effective tools to not just weather the current crisis, but come out stronger on the other side.
* Disclosure: This article is authored by EarlySense, the producer of the technology used by Sheba Medical Center and the sponsor of the study cited above. To learn more about our contact-free continuous monitoring (CFCM) solutions, you can request a consultation here.