In the context of the COVID-19 pandemic, patients, providers, and policy makers may well consider the role that home health monitoring devices and the data derived from them might play in how care is provided to patients in the future.
Stay at home and social distancing policies across the U.S. have had a serious impact on face-to-face encounters, yet the need to monitor the health and stability of individuals, particularly those with poly-chronic disease and co-morbidities does not go away. Further, for providers participating in advanced payment models, which attribute specific populations of patients to a practice, the impetus to manage and coordinate the cost and quality of care remains.
Embracing the benefits of such devices such as smart watches, glucose monitors or blood pressure cuffs, which can promote self-management, reduce the need for laboratory diagnostics and improve adherence to a care plan, needs to be balanced with risks and liability considerations.
Providers, patients and policy makers should be concerned about device accuracy, precision and where the data collected through such devices lives, along with the privacy controls in place to prevent misuse. Standards for how data is normalized, transmitted and integrated with electronic health records and population health management platforms have struggled to keep pace with the technological advancements which have brought hundreds of new devices to the market.
From the patient’s perspective, wearable devices and remote monitoring equipment provide convenient, real-time information on key indicators to help them manage their condition. For example, a blood pressure cuff can allow a person with hypertension or recovering from a cardiac procedure to measure systolic and diastolic blood pressure, often with the ability to track and trend their readings via a smartphone-based application. Others might use an Apple iWatch® with its ECG app to record their heartbeat and rhythm using the electrical heart sensor and then check the recording for atrial fibrillation, a form of irregular heart rhythm. An alert on a digital glucose monitor can identify dangerously high or low glucose levels, prompting a diabetic patient to adjust their blood sugar levels with food or insulin.
Providers have seen a plethora of new devices appear in the past decade and can counsel patients on which devices have been validated and are appropriate tools for remote monitoring. Patients need to be trained on how the devices operate, and work with their provider to interpret readings to know when they should call their physician or seek medical care. Human factors, being able to use the device correctly in its intended way, is a key enabler to ensuring these tools add value to the care relationship. Embracing wearable devices and the data they generate may serve as a way to extend care outside the doctor’s office walls, not only during the current pandemic but into the future.