Remote Patient Monitoring: The 21st Century Approach to Treating Chronic Disease

At the turn of the last century, the three major causes of death worldwide were all acute, infectious diseases: tuberculosis, typhoid, and pneumonia. Treatment for these diseases was relatively simple, once antibiotics were invented. Today, seven out of ten deaths each year are attributable to chronic disease, and more than 75 percent of the $3.8 trillion we spend on healthcare in the United States each year goes toward treating chronic disease. The nature of disease has fundamentally changed, yet our approach has not—and this omission is costing the healthcare system, and patients, dearly.
 
The 21st century approach to healthcare must change its medical paradigm and delivery model to better address the burden of chronic disease. That’s because chronic diseases are difficult to manage, expensive to treat, often require multiple physicians, and typically last a lifetime. The conventional medical paradigm focuses wrongly on either suppressing the condition with drugs or intervening at a point when the condition has already progressed to a debilitating stage. Our contemporary delivery model is wrong, too because it’s not structured to recognize and support the critical role that patients play in preventing, managing, and reversing chronic disease.
 
After all, more than 85 percent of chronic disease is caused by environmental factors like diet, behavior, and lifestyle. With the advent of remote patient monitoring and medical wearable devices, we finally have the necessary arsenal to tackle the challenge of chronic disease. Remote patient monitoring that utilizes mobile medical devices and allows for the collection of continuous, real-time data enables a new medical paradigm and delivery model ideally suited for the prevention and management of chronic disease.
 
A New Medical Paradigm
A “one disease, one doctor, one treatment” approach does not fit the current chronic disease landscape, as 42 percent of adults in the United States have more than one chronic condition. In fact, almost one-fourth of costs for chronic disease care are attributed to comorbid conditions. Treating a patient for one chronic condition and neglecting a comorbid condition would be ineffective and potentially lethal. To succeed where chronic disease is concerned, our contemporary healthcare system has to move to a more “holistic” approach wherein patient data is consolidated, and patient metrics are recorded for all vital signs and markers.
 
For example, treatment for morbid obesity often leads to extreme measures, such as gastric bypass surgery. Yet, obesity contributes to other chronic conditions such as hypertension and diabetes that remain unsolved from such measures. If the physician becomes aware that the obesity is present along with one or more of the other comorbid conditions, he or she might recommend a different care regimen. Here, remote medical mobile devices can help achieve the needed clarity physicians require to treat a patient in light of multiple chronic conditions. When these devices collect a wide range of patient metrics and vitals in real time, they assist physicians in detecting patterns and nuances in the morphology and progression of a disease they might otherwise miss through infrequent face-to-face visits. In some cases, data for patients who see multiple physicians for different chronic conditions has to be consolidated as well, so physicians and care providers have access to relevant cross-specialty data.
 
A New Healthcare Delivery Model
Today’s healthcare delivery model still revolves around sporadic, and often short, face-to-face physician visits. This model works well for acute diseases and conditions where intervention is applied (e.g., antibiotic is prescribed) and recovery becomes a by-product of the isolated intervention itself. Chronic disease, on the other hand, relies heavily on a continuous delivery of care. Consider the average patient visit with a primary care provider (PCP) lasts about 13-16 minutes. If a patient presents with multiple chronic conditions, is taking several medications, and has new symptoms, it would be nearly impossible for the PCP to provide quality care during that visit—let alone discuss in detail the diet and lifestyle changes the patient should follow. And, if the PCP did address lifestyle changes with the patient, what is the guarantee the patient would actually follow the prescribed care regimen without any oversight or real-time follow up before the next face-to-face appointment? After all, studies have shown that knowledge and information alone do not effectively change patient behavior.
 
Remote medical mobile devices enable a new healthcare delivery model that improves chronic disease prevention, management, and outcomes in two ways. First, these devices collect continuous, granular, and real-time patient data. Physicians can see whether a care regimen is having the desired outcome on the patient’s condition, and how the patient’s metrics fluctuate in response to medication, diet, lifestyle, etc. If needed, a physician can initiate a timely intervention and adjust the care regimen before the next face-to-face visit; thereby, shortening the feedback loop. Mobile medical devices can also assist physicians by focusing data collection to the metrics and markers most relevant to the physician and have direct clinical impact for the patient’s condition.
 
Second, remote medical mobile devices can incorporate health coaching, emphasizing collaborative care in which patients take an active role in the management of their own health. Through health coaching, patients input data, get reminders to take their medications, and receive immediate positive feedback from their mobile devices—becoming more mindful about their health. Increased mindfulness translates to long-term medication adherence and positive lifestyle choices. One 2017 study employed in-home and wearable health devices to successfully demonstrate the effective use of patient-generated health data to better manage and engage patients suffering from both Type 1 and Type 2 diabetes. The results of the study demonstrated patients found the devices and applications in their care program as an enhancement to their quality of life as they enabled them to better self-manage their diabetes. Patients also found the remote monitoring program strengthened their relationship with their care team (inclusive of the physician, nurse, and nutritionist) and eased the burden on them to manually record readings and attend weekly in-person visits. The results of the study confirmed personal medical devices and apps that incorporated feedback were associated with behavioral change. Patients became more engaged with their health both by manually inputting data into mobile devices and by receiving clinically relevant data, such as a blood pressure reading, from their devices. Health coaching can help the patient build awareness, encourage them to become their own health advocate, and support them in developing the skills they need to sustain new behaviors.
 
Conclusion
Assisting physicians with better workflow management and better access to clinically relevant data is important in today’s chronic disease landscape, yet arguably the most important role healthcare can play today is supporting patients in making positive behavioral changes. Patients play a significant role when they make the right choices about their diet, physical activity, sleep, and stress—consistently and over the span of their lifetime. Remote, mobile medical devices position the patient as a partner in the journey to better health, and in so doing provide one of the greatest resources in overcoming the burden of chronic disease.
 

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Waqaas Al-Siddiq is founder and CEO of Biotricity, a biometric remote monitoring solutions company. He is a serial entrepreneur, a former investment advisor, and expert in wireless communication technology. He has vast experience through executive roles within start-ups, mid-sized companies, and non-profits. For more information, visit www.biotricity.com.