What makes for a successful remote patient monitoring program?

“What 5 things make for a successful telehealth (remote patient monitoring) program?” was a question I [Ed. Steve] was asked recently. This was my response:

  1. Physician and nurse enthusiasm
  2. An ambitious implementation plan (speed and scale)
  3. A liked and respected project manager
  4. Realistic publicity
  5. Reliable technology

Oh… and physician and nurse enthusiasm.

Perhaps readers have a different set of suggestions?… Leave a comment

8 thoughts on “What makes for a successful remote patient monitoring program?

  1. Priorities and a bit more…

    School of Hard Knocks experience:

    1. Physician/nurse and other clinical staff enthusiasm.  Youcan have the greatest system in the world and management’s bought it, but if the implementers don’t love it, you’ll be out in six months.  Their inertia, ranging to downright hostility (to change, to reporting and work) can kill your product in the situation and through word of mouth.

    2a. Reliable technology and reporting. Nothing dims enthusiasm like the system kicking out false information or false alerts frequently and unfixably. This is not the occasional glitch or battery out. The system needs to be reliable, the reports need to be understandable and to a realistic degree, customizable.

    2b. Liked and respected project manager…and account manager for follow up. This is so critical that I can’t rank it as #3 because it is the human side of the technology. The project manager is trainer, handholder, cheerleader, psychologist, troubleshooter, liaison, problem solver. This person may then become the account manager (a common situation in small companies) after all this is done…or a new person takes over, but you need the same qualities. It’s also critical to future sales within the organization.

    3. Ambitious implementation plan. If your company is content with 10 person pilots, you will waste a lot of time and churn accounts.  Combine this with # 1 and 2, and you will spool up a lot faster.

    4. Customer service.  Your safety net for the integrity of your service: account manager, experienced and cheerful office staff (including IT, who sometimes need to be trained to speak with customers) and 24/7 backup. Problems DO happen, and inevitably at night and on weekends. The old adage is true–it’s often not the problem, but how you handle and solve it. It shows you care about their business.

    5. Realistic publicity. Yes, don’t overpromise! But also bring your customers into your outreach, whether it’s community, industry or the press. Case histories, releases, TV, online, Facebook and Twitter are all ways of giving back to them (and to people who are often unrecognized for their hard work) as well as promoting your company.  It is a powerful tool in your kit because skillfully done, it rewards both sides.

  2. Stakeholder alignment around definition of success

    We’ve implemented one telehealth program in the Pacific Northwest over the past four years (under the rubric of a Medicare demonstration program) with a current intent-to-treat population of about 3,000 Medicare beneficiaries (1,000 of whom are currently enrolled). We started another one in the Bronx last year, also under Medicare, with an intervention population of about 6,600 (about 1,500 currently enrolled).  [Ed. note:  Bosch Health Buddy test at Montefiore Hospital TA 25 Feb]

    I agree that physician and nurse enthusiasm are critical. But even before that, the critical success factor is making sure that all stakeholders are aligned around how success is defined. That includes payers, providers, and patients. All of them will see different faces of the issue, but all of them have to get something out of it, so while that doesn’t mean they all get exactly the same thing out of it, those goals need to be mutually reinforcing. Even with a healthcare organization, different functions will have different goals — i.e. the doctors and nurses want better workflow and quality, while the CFO wants either a profitable revenue stream or measurable efficiency improvements (probably both). And then there’s the CIO, who just wants to make sure everything hangs together and works.

  3. Evaluation and positive results
    Any program requiring investment of this sort needs to be subject to suitable evaluation that demonstrates true benefit to the patients and cost savings to the health care system.

  4. Finance and autonomy

    In the UK the stumbling block appears to be lack of a secure funding stream free from attack from competing sources. Also the nature of the tendering process and manipulation previously featured on this site stifle small providers. Any thoughts from others with experience welcome.


  5. Re: What makes for a successful remote patient monitoring program?

    Well – you guys all seem to have left out the most important things:

    • The patient – without a cooperative and willing patient then the system will fail for that person every time. A willing and enthusiastic patient should be able to effectively implement his own system.
    • The monitoring equipment – needs to be simple effective and cheap.
    • The software – there has to be effective intelligent software that will flag warning signs without human intervention of any sort. Even ask for more information. The patient can then contact the nurse or doctor (or the software could do this automatically). The basic monitoring equipment has been available direct to patients for years, and there are a lot of patients with computers. What is really lacking is available software for those home computers!

    There are simply not enough nurses and doctors anywhere to provide this sort of care to all the chronically ill.

  6. Engagement and Technology

    I would put patient engagement first on the list, it’s very difficult to achieve anything when people are dis-engaged. Physician and nurse enthusiasm are important because it is a major driver for patient engagement. If the clinical staff is enthusiastic and engaged then the patients are likely to be enthusiastic and engaged too.

    Technology needs to be more than reliable. It should be engaging, and if at all possible it should be fun. Telehealth programs are competing for the participants time. Television, movies, sports, games, bill paying, work, and household chores are all demanding the patient’s attention. Why should they spend their time on the telehealth program? Their health is important, but may not seem as urgent. Technology is not the whole solution to this problem but well designed technology can help with it.

  7. A different perspective

    I am writing from the perspective of monitoring patients with mental illnesses.

    1. The effectiveness of remote monitoring is very dependent on the patient being engaged and pro-active about their mental health. They must understand the benefits of their own monitoring, which is the primary focus, in addition to the advantages in being monitored externally. This is different to physical illnesses, where active patient involvement can be less central to the remote monitoring.

    2. Remote monitoring needs to be efficient and cost-effective for the health provider.

    3. The items being monitored must be thorough and individual specific.

    4. Remote monitoring is collaborative; it must be effective in preventing new episodes of illness and early intervention.

    5. The provider and patient must communicate clearly on expectations, the scope of monitoring, and boundaries for intervention.

    We are in late development of a monitoring system that interfaces with our patient app (http://www.optimismonline.com). The mental health provider will be able to automate the receipt of periodic reports and charts, and daily health updates for all patients. Patient specific alerts may also be set to catch situations where intervention may be required, sent by email and/or SMS.

  8. Low cost remote health monitoring by VESAG

    Two weeks back I went to mHealth Summit at Washington D.C and I found a company from India who is into remote health monitoring. please look at their website http://www.vesag.com and here is the brief description of their service.

    VESAG is a comprehensive service to support senior citizens and Dementia patients. VESAG provides vital support by providing the location information (patient tracking) and a means to communicate with them. It acts as a programmable secondary memory. Care givers can program the device with all the key details like name, address and contact details to remind the patient when needed. At normal times, it reminds patients of tasks such as taking medication at the prescribed time. In more advanced version it can detect fall and monitor the key health parameters such as heart rate, ECG, blood pressure, body weight, etc. and transmit the data to a central monitoring station through wireless technology, which can then be forwarded to a doctor or a care giver for periodic monitoring. VESAG stores all the past medical history, current medications, specific allergies and the contact information of care givers which can be used during emergencies. Care givers can set thresholds for critical health parameters to alert by SMS/voice call when these thresholds are crossed.

    Such a comprehensive system can provide a tremendous emotional relief to care givers by ensuring a constant round the clock digital monitoring. Patients will benefit with the additional digital memory support and the freedom to move in the society.

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