Reimagining remote patient monitoring

Telemedicine, or telehealth, enables health-care providers to deliver care via technology and, in many cases, virtually via a telehealth software app that is accessible on a smartphone, tablet, or desktop. But it is much more than that now with wellness trackers that can be integrated into a patient’s health-care records and remote patient monitoring (RPM) that enables health-care providers to monitor and review health data electronically.

RPM is growing on two fronts: to improve patient care and to reduce health-care costs. By tracking a patient’s health, including blood pressure and glucose monitoring, RPM can alert doctors to early warning signs that enable them to take action, reducing emergency room visits and hospitalizations. RPM can also lower health-care costs for some of the same reasons — reduced emergency room visits and hospitalizations — as well as reduce the need for patients to be physically at a medical facility.

The Covid-19 pandemic curtailed a lot of doctor’s visits and medical tests and certainly has spurred some of the growth in the RPM market along with an aging population. The global RPM market is a huge and fast-growing segment of the medical industry, with a compound annual growth rate of 26.7% over a forecast period of 2022–2027, according to a MarketsandMarkets Research report.

The RPM market is forecast to to reach $175.2 billion by 2027, up from $53.6 billion in 2022, driven by several factors, according to the report. These include reducing the burden on medical resources, lowering costs, increasing geriatric population, and the growing need to expand health-care access. Another driver is more advanced telecommunications technologies.

A big part of the demand is driven by the need to monitor chronic diseases, such as cardiovascular, hypertension, diabetes, and respiratory, especially among the elderly, who require a high level of care.

This growing demand has resulted in more innovative and connected devices like blood-pressure cuffs with ECG, heart-rate monitors, and glucose monitors, as well as wearable wellness devices. There is also more integration of monitoring data and services into smartphones and other wireless devices. It has also spurred new applications such as medication adherence and location tracking of people at risk of wandering.

Connecting with doctors

Omron Healthcare, Inc. has been working on digital connected heart-health services and products over the past several years. At CES 2022, Omron introduced new RPM services, connected blood-pressure monitors, and an advanced mobile app. These new solutions are all part of the company’s mission of “Going for Zero” heart attacks and strokes. Omron also has a collaborative research initiative underway with Kyoto University that is investigating how artificial intelligence can analyze blood-pressure metrics to predict cardiovascular diseases accurately at an early stage.

Omron’s VitalSight service for hypertension management is designed to drive more remote monitoring as well as communication between patients and their doctors. The more data the doctors have, the better their treatment decisions for improved outcomes.

The VitalSight kit includes an Omron connected blood-pressure monitor and data hub that are preset to securely share measurements with the patient’s doctor and care team. It can be integrated with the clinician’s electronic medical record (EMR) system or through the Omron Doctor Dashboard for analysis, which provides automatic notifications when a patient’s readings require action.

Omron said this has become even more important during the Covid-19 pandemic, with patients not keeping up with their routine checkups and not going to the hospital when experiencing symptoms.

The company also offers the Omron Connect mobile app that works as a personal heart-health coach. It syncs with all Omron connected devices and provides insights into your blood-pressure readings. It also provides guidance to manage hypertension and incentives for behavior changes.

Users can store, track, and share their data securely with a doctor. It also provides an option to sync data with the Apple Health and Google Fit platforms to integrate reports on heart health, activity levels, and sleep quality.

Omron plans to add more features to personalize the app experience. These upgrades will include more data analytics, additional support for hypertension management, and an option to engage with other app users as a global support community. It’s available as a free download in the Apple App Store and Google Play.

On the hardware side, Omron Healthcare developed a home-use blood-pressure monitor + ECG to help detect atrial fibrillation (AFib). The product also hopes to spur patients to monitor and record their blood pressure every day by making their risk of AFib visible through ECG measurements.

By adding an ECG recording function to a blood-pressure monitor, it enables users to monitor and record both measurements on a daily basis. This can contribute to the early detection of AFib in hypertensive patients. This device is also connected via RPM services to send the ECG data to doctors for diagnosis.

Connecting people to their health and encouraging behavioral change is also driving technology advances. One example is a recently announced partnership between Braidio and BlueSemi for preventive and connected home health and telehealth. The partnership leverages BlueSemi’s EYVA handheld device, which measures six key vitals including blood glucose without requiring a pinprick for blood, and Braidio’s My Health Concierge platform.

EYVA uses sensor fusion, AI, and IoT. The device’s haptic sensors respond to the user’s touch, which can mirror their breathing patterns to measure blood glucose, ECG, heart rate, blood pressure, SpO₂, and HbA1c in 60 seconds, said the company. No blood is required, as users just touch the device as they touch their phone screens. With the new partnership, the data can be available through Braidio’s My Health Concierge.

My Health Concierge provides health-care workflows, including triggered events and write-back capabilities, to the major EHRs. RPM ensures that medical teams have the latest patient data and insights. The company said it eliminates barriers that previously prevented ease of access to care across the ecosystem, connecting family members and doctors in one application.

A personalized app allows patients to manage care and appointments with a central location while also sending test and vitals results directly from EYVA.

The future of medicine will also include remote procedures at home. Medtronic plc, for example, was granted 510(k) clearance for its PillCam Small Bowel 3 system for remote endoscopy procedures by the U.S. Food and Drug Administration (FDA). It is only cleared for remote use in the United States. Medtronic’s PillCam capsule endoscopy has been used for more than 20 years as a minimally invasive option detection of gastrointestinal diseases.

The PillCam SB3 @HOME is a telehealth option for visualization and monitoring of the small bowel to help better detect lesions not detected by upper and lower endoscopy. It can be used to indicate Crohn’s disease, locate obscure bleeding, or identify sources of iron deficiency anemia, said Medtronic.

How it works: The PillCam SB3 @HOME kit is delivered directly to the patient. Through a telehealth appointment, a health-care provider guides the patient through the remote procedure. A camera inside the capsule can capture images at a frame rate of two to six frames per second, depending on how fast it travels through the small bowel.

Over the eight-hour procedure, the capsule will transmit about 50,000 images, which are securely transmitted to the cloud, where a GI physician reviews them to make a diagnosis, said the company. The third-generation capsule also includes proprietary software algorithms that enable smarter video compilation that is said to be 40% more efficient than the PillCam SB2 system.

Some RPM devices are also used in hospital settings to improve patient care while lowering cost and helping in patient comfort. In September 2021, Caretaker Medical, announced U.S. FDA clearance of the company’s next-generation VitalStream wireless blood pressure and hemodynamic monitoring platform. The company said it delivers ICU-grade monitoring that surpasses regulatory certifications and clinical accuracy validation requirements.

VitalStream provides continuous “beat by beat” monitoring of blood pressure in real time, eliminating monitoring gaps associated with intermittent spot-check hemodynamic and vital-sign measurements, said the company. It also eliminates the need for continuous measurement via an invasive arterial line, which can be costly.

VitalStream uses a low-pressure finger sensor, and its hemodynamics, waveforms, and vital-sign data can be streamed remotely to the company’s mobile app or secure cloud portal. It can also be integrated into other monitoring systems and EMRs with their FDA-cleared software interface SDKs.

The company’s latest VitalStream platform expands on the previous-generation Caretaker4 wireless patient monitor and pulse decomposition analysis and AI algorithms with new features. These include advanced hemodynamics, automated NEWS/MEWS early warning scores, higher-resolution data and waveforms, 30-second auto-calibration and setup time, streamlined clinical workflow, more data connectivity options, and a smaller wearable form factor.

New RPM applications

In addition to monitoring for health, RPM is expanding into other areas like medication adherence and “wander” tracking for people at risk due to Alzheimer’s, dementia, autism, or traumatic brain injury.

Medication adherence is a growing segment, particularly for elderly patients. One solution is CuePath Innovation’s second-generation CueCare connected and protected medication-adherence solutions for home health-care agencies.

Through its Innovator Program, CuePath’s home-care–agency partners integrate its medication-adherence service into the care plans of its elderly clients and is said to be effective at improving adherence in as few as four weeks.

The system uses CuePath Certified Pharmacies to deliver blister packs to CuePath’s home-care–agency partners’ patients and helps patients to follow the medication-adherence regimen. The CueCare system tracks when medications are taken or missed and if incorrect compartments are opened at the wrong time. The system enables the caregiver team to engage directly with the patient to remedy the situation, said the company.

The solution features Thirdwayv’s cybersecurity protection. CuePath said it has strengthened the security of communication links that are used between CuePath products in the home and the CuePath cloud service to improve overall performance and reduce counterfeiting risks thanks to its collaboration with Thirdwayv.

For location tracking, GTX Corp., a provider of location-based wearable GPS human and asset-tracking systems, and ProteGear.com, a German IT/GPS tracking specialist company, have collaborated on the launch of GTX’s latest-generation GPS SmartSole product based on LTE Cat M1 technology.

The SmartSole is GTX’s GPS-enabled wearable device, now with a longer battery life of up to five days. It uses a Nordic GPS module connected through cellular networks that send a GPS location to the GTX central monitoring website and app.

The GPS SmartSole is an “invisible” tracking technology placed in the wearer’s shoes. The target market is people with cognitive disorders such as autism, dementia, traumatic brain injury, and Alzheimer’s who tend to wander and need constant remote patient monitoring, said GTX.

SmartSoles are available in trim-to-fit sizes, ranging from sizes 5 to 13, for men, women, and children and are water-resistant. They include an inductive charging pad and are manufactured in Rhode Island.