Tech & Innovation in Healthcare

Remote Patient Monitoring:

Take Control of Diabetes Management with Continuous Glucose Monitors

Adding technology to care plans may still be a hurdle for senior patients.

Remote patient monitoring (RPM) allows patients to attend routine follow-up appointments and stay in contact with their healthcare teams to ensure treatment plans stay on course — all without having to risk further illness during the COVID-19 pandemic.

Read on to get the scoop on how your practice or facility can help patients stay on track, while also improving patient satisfaction.

Find the True Value of Virtual Care

Studies have shown that patients enjoy the convenience of telehealth visits, but can RPM and telehealth streamline healthcare? Experts think so.

“RPM has the potential to help us re-think the influence we as healthcare professionals impose on people’s time and connect with people in ways that fit more meaningfully into a person’s life,” says Christopher J. Norman, MSN, APRN, GNP-BC, geriatric nurse practitioner for PACE CNY (Program of All-inclusive Care for the Elderly of Central NY) in East Syracuse, New York.

Nearly two years ago, due to the pandemic, healthcare providers had to quickly change the way they deliver care to their patients. Whether patients are experiencing chronic conditions, require frequent check-ins, or need to see a physician for an acute sickness, healthcare professionals found ways to ensure they continued to provide treatments.

By pivoting to telehealth and virtual care services, providers were able to provide better care and value. Providers saw value in virtual care that extended beyond the financials. The value streams include, but are not limited to, physician satisfaction experience; clinical outcomes, quality, and safety; and access to care. Additionally, a study conducted by American Medical Association (AMA) researchers, Meg Barron and Vimal K. Mishra, MD, found “that 75% of clinicians polled by the organization indicated that telehealth enabled them to provide quality care and 68% of respondents are motivated to increase telehealth use in their practices” (https://www.ama-assn.org/practice-management/digital/uncovering-true-value-telehealth-improve-care-outcomes).

Take a Proactive Approach to Diabetes Management

For some patients with diabetes, monitoring their glucose levels can involve multiple finger sticks during the day, which can be disruptive to their daily lives. Real-time and intermittently scanned continuous glucose monitors (CGM) allow patients with diabetes to easily track their blood sugar levels on a smartphone or tablet. The monitor uses a sensor with a small wire catheter implanted in the patient’s arm or abdomen to measure the glucose during the day. A transmitter equipped with Bluetooth is attached to the sensor, so the patient can review the numbers on a handheld receiver or their smart device.

Which monitor do you pick? “In general, continuous glucose monitoring is best for people with type 1 diabetes,” Norman says. Patients should also consult with their physician or other qualified healthcare professional to determine which device would be best suited for their needs.

Using CGMs for RPM can be an excellent method for patients to have greater accountability and ownership over their illness. In a 2019 RPM diabetes management study, researchers found that patients who frequently and regularly participated in remote monitoring showed lower HbA1c levels at the program’s conclusion (https://pubmed.ncbi.nlm.nih.gov/30372366/).

Without appropriate interpretation, the data behind diabetes management with RPM can be overwhelming for some people. Some experts believe patients could lose sight of their treatment goal or several factors that influence successful diabetes management simply by focusing on the numbers on their monitor.

However, with the right patient, RPM can “promote insight and interaction in an individually meaningful way with the healthcare system,” Norman says. The monitoring allows patients to become experts on their numbers while healthcare professionals are available to provide interpretation and perspective on what those numbers mean to the patient’s overall health.

Skip the Trip to the ER or Urgent Care

If your healthcare providers see pediatric patients, this scenario is probably familiar: The child wakes up in the middle of the night with an earache. They’re inconsolable and the pain is so severe that the parents can’t wait for your office to open and rush the child to the emergency room or an urgent care clinic.

But what if you could offer a solution in which the patient didn’t have to leave the comfort of their home for evaluation? What if they had the tools in their home for your provider to perform an exam?

With RPM, healthcare providers can provide near-bedside care simply by having the patient turn on a laptop or tablet. One company, TytoCare, has developed a medical examination kit, so physicians can diagnose a patient’s condition over a telehealth call. Approved by the Food and Drug Administration (FDA), the kit includes a video camera and clinical-grade otoscope, stethoscope, temperature monitor, and tongue depressor applicators.

When the patient starts the video call, the provider joins and walks the patient through a virtual exam using these medical devices on themself or, as in this scenario, on their child, explained Robin Farmanfarmaian at AAPC’s HEALTHCON 2021. “And because the doctor is seeing the live video camera feed, it’s almost as if she’s putting her hands through the computer screen,” Farmanfarmaian added. For example, the patient could be handling the stethoscope so the physician can listen to the patient’s heart or lungs, and the physician can direct the patient to move it to the left or the right, so they could hear the organs better to make an accurate diagnosis.

Help Patients Comply With Treatment Plans From Home

The explosion of telehealth services and RPM technology has transformed how patients can receive the care they need. As they enter their golden years, senior patients can maintain a connection to their preferred healthcare professionals with audio and video communications or phone calls without having to leave their homes to receive care.

RPM also has the potential for healthcare providers to better allocate their time depending on the needs of their patients. The technology lets providers keep a watchful eye on their patient’s conditions and intervene as necessary. Plus, while there may not be a reduction in time spent providing care, how providers deliver that care is the difference. “RPM can help me determine what type of visit is necessary, whether in-person, telehealth, or just a phone call,” Norman says.

Additionally: RPM and telehealth provide coverage in between home health visits, as well. RPM can deliver an automated reminder or a provider can make a telehealth call to remind the patient to take their medication and confirm the medication has been taken. Certain devices, such as blood pressure monitors or CGMs, can deliver an early indication that an older patient’s condition may be worsening, so your provider can intervene.

Expect Some Challenges Still

Younger generations appear to be highly receptive to RPM and telehealth, as evidenced by the popularity of wearable connected devices, such as smartwatches and fitness trackers. Do older patients share the same excitement surrounding these technological advancements?

“It all depends on the person, the technology, and the approach by which the technology is introduced to the person,” Norman says. Senior patients may not feel comfortable using a tablet, but most are savvy with a phone and don’t have trepidations about calling someone to help.

“The right kind of technology with the right kind of older person can be lifesaving and/or harm-reducing, but one size does not fit all in the diverse older adult population. Overall, in my opinion, it can be a positive as a supplement to a well-structured, individualized healthcare plan,” Norman says.

Bottom line: Be prepared to work with your patients on the best solutions for them to ensure care continuity. Consider letting technology help you help your patients when appropriate.

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