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As clinicians know, addressing the needs of patients living with chronic conditions, such as heart failure, Type 2 diabetes or hypertension, places a high level of strain on primary care providers and health systems. Although these patients require ongoing monitoring and regular check-ins to manage their conditions and help keep them out of the hospital, we typically see them in clinic only once or twice per year.
That is what interested me recently when I decided to recommend a new remote patient monitoring program. Utica Park Clinic in Tulsa, Okla., where I am a practicing family physician, has been offering an RPM program called Cadence to such patients for the past year, and I couldn’t be more pleased with the results.
The technology is simple for patients to use. They receive a set of mobile device–enabled blood pressure monitors, scales and blood glucose monitors. Patients take their vital readings from the comfort of their own homes each morning. Their readings are automatically uploaded and reviewed by Cadence’s clinical care team, who are able to make medication adjustments as needed in consultation with me.
By keeping close track of patients between their visits, I am better able to manage their conditions and improve their overall health more quickly.
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Better Experiences for Patients and Providers
While I was initially skeptical of how patients would take to this technology, they really like it because it’s easy to use and helps maintain their health improvements. Most of these patients want to have closer supervision without hospitalization, and with these devices and the medical team that backs them up, the extra support they need is always close by.
Patients who live in rural areas may have to drive for one or two hours to a clinic for something as simple as a medication change. With RPM, medication adjustments can be made without a trip to the office. Patients also are reassured between visits by knowing someone is keeping an extra eye on their health, which in turn makes them more accountable and engaged with their own care. Many have told me that they never knew when their blood pressure or weight were out of range. With better knowledge, they are starting to develop healthier habits and learn how to prevent swings in their health.
The program is equally beneficial to me as a practicing physician. Knowing experienced clinicians are monitoring patients’ blood pressure, blood sugar and weight — and catching small trends in the wrong direction — has taken weight off my shoulders and greatly reduced the pressure on clinic staff.
EXPLORE: How do remote patient monitoring and AI personalize care?
How RPM Programs Develop Teamwork
Admittedly, one concern when starting the program was that I would lose control of medical decision-making for my patients, but the reality has been the opposite. Working with the remote clinical team has been structured and seamless because it is fully integrated into our electronic health records system, and we have adopted a team-based approach, where the remote clinicians can review my notes, see what medications the patient has tried before and reach out to confirm any suggested medication change with me.
The RPM program provides complete data and allows us to quickly determine, for example, whether a patient’s blood pressure has stabilized. We can then move forward with a medication refill rather than having the patient in clinic for an office visit and a new round of labs.
Across Utica Park Clinic, we are now monitoring more than 1,400 patients. Before enacting this program, many patients would come for their office visit and show elevated blood pressure because they were a little anxious. This could have led to unnecessary or potentially harmful adjustments to their medication. Since we’ve been able to monitor them at home with daily readings, we’ve discovered that they are doing better than we thought. That’s an excellent example of one of the best parts of RPM: It provides a more accurate and comprehensive picture of how well a patient fares at home and enables us to give them the best possible care.
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