The Future Belongs to Remote Patient Monitoring

The Future Belongs to Remote Patient Monitoring John Halamka

The bionic woman and the bionic man are no longer fictional TV characters. With the help of state-of-the-art digital technology, they’re your next-door neighbor.

By John Halamka, M.D., President, Mayo Clinic Platform, and Paul Cerrato, senior research analyst and communications specialist, Mayo Clinic Platform.

By one estimate, 30 million Americans will be using remote patient monitoring (RPM) devices by 2024. By 2027, the global RPM market will reach $1.7 billion. Developers, digital health leaders, and clinicians must pay attention to this growing segment of the health care ecosystem. These tools touch almost every medical specialty and can potentially improve the lives of countless patients in primary care settings.

In the past, when RPM entered the discussion, portable blood pressure devices and blood glucose meters came to mind. But the industry has moved far beyond these useful tools. The first glucose meters became available in the 1970s, and their accuracy, cost, and usability have steadily improved. Since the introduction of continuous glucose monitoring (CGM), they have enabled patients to have much more control over the disease and enabled clinicians with the right online resources to detect trends in metabolic control over time. And with the help of products like Abbott’s FreeStyle Libre, patients no longer have to endure daily finger pricks to measure changes in BG levels.* The impact of CGM systems on patients’ well-being can hardly be overstated. For those self-disciplined enough to actively participate in their own care, their impact can be life-altering!

Patient-friendly BG monitoring systems like this are just the tip of the digital iceberg. ECG sensors are now available in smartwatches and standalone strips, with the ability to detect atrial fibrillation and other arrhythmias. Electronic skin patches are outfitted with wireless transmitters that enable clinicians to monitor a variety of useful parameters, including vital signs. They are also being used in wound care and motion detection. Hydration and sweat sensors are helpful for anyone who needs to watch for dehydration, while photoplethysmography (PPS) sensors give clinicians essential data on oxygen saturation and a variety of other parameters.

Bluetooth technology is also playing a role in this RPM revolution. Propeller Health, for example, has a sensor that can be attached to a medication inhaler. The bottle cap-sized Bluetooth sensor informs patients when they are not administering the correct dose of medication; it can be linked to a mobile app to improve the management of asthma and chronic obstructive pulmonary disease, or COPD.

Similar advances in RPM technology have been documented in neurology, including Parkinson’s Disease assessment. Dutch investigators have demonstrated that a smartwatch can be programmed to help evaluate and monitor motor functioning among patients with the disease. Their virtual motor exam required patients to perform a set of tasks, including raising and twisting their arms and getting up from a chair, which were recorded by the smartphone they wore on their wrist. The data helped clinicians evaluate several clinically essential signs, including rest tremor, bradykinesia, and arm swing during gait, enabling them to judge disease severity and response to medication.

A recent experiment at the University of Padua, Italy suggests that remote systems will eventually enable patients to steer their own wheelchairs with their thoughts. With the help of scalp electrodes, a brain/machine interface was created that recorded neural activity. “After training, the participants drove a wheelchair — augmented with sensors and robotic intelligence — around a cluttered room.”

These digital tools will sound familiar to readers old enough to recall the TV series about the bionic man. While today’s RCM devices may not give users the skill set of the Six Million Dollar Man, they offer very real benefits to a wide array of patients.

*Footnote: Mention of commercial products does not imply endorsement by Mayo Clinic.

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