The healthcare sector must explore every weapon in its arsenal to continually fight and control COVID-19.
COVID-19 has continued to spread across the nation, with the current focus shifting to how we can safely return to the office, open schools, play fall sports and more. But as our country works to contain the virus and prevent further outbreaks – especially with the looming flu season – it's clear that new approaches are needed to slow the spread and flatten the curve once and for all.
Technology is playing a crucial role in this fight, with rapid development of solutions that involve contact tracing, enable remote care, provide thermal scanning and much more. The next wave of innovation in the fight against COVID-19, however, must focus on expanding the use of remote patient monitoring (RPM) tools to help predict future outbreaks and serve as early warning systems for detecting the virus in individuals in order to contain exposure and spread.
Increasing Interest in Automated Remote Patient Monitoring
Before the pandemic, RPM was becoming more widespread. About 88% of healthcare providers said they had invested – or were evaluating – RPM technologies such as tools to measure blood pressure and blood glucose. As the pandemic enveloped the globe, use of RPM for chronic conditions grew even further as providers were trying to limit in-clinic visits and potential exposure for high-risk patients.
The pandemic also led healthcare leaders to look at new ways to remotely and automatically detect signs of COVID-19 in asymptomatic or pre-symptomatic individuals, or perhaps identify signs of long-term side effects, such as heart and lung damage, that has been linked to the virus. RPM tools seemed the obvious choice.
The U.S. Food and Drug Administration issued a new policy in mid-March 2020 that enabled manufacturers of certain FDA-cleared non-invasive, vital sign-measuring devices to expand their use so that healthcare providers can use them to monitor patients remotely during the COVID-19 crisis. “Allowing these devices to be used remotely can help healthcare providers access information about a patient’s vital signs while the patient is at home, reducing the need for hospital visits and minimizing the risk of exposure to coronavirus,” FDA Principal Deputy Commissioner Amy Abernethy, M.D., Ph.D. said at the time. In addition, The Centers for Medicare and Medicaid clarified that RPM was reimbursable both for chronic conditions and acute conditions – like COVID-19.
But the potential is greater than simply monitoring patients who may need consistent care for chronic conditions, or who are hesitant to venture out and potentially be exposed to COVID-19. Since RPM technology is digitally connected and non-invasive, healthcare providers can use these tools to monitor temperature, pulmonary function, blood pressure and other physiological changes to not only identify individuals with the disease, but to watch for emergency warning signs of more serious problems, such as difficulty breathing. If pulse-oximetry falls below prescribed levels, for example, patients will know to seek further care, and they will be flagged as high-risk to their provider.
The Next Step: America Needs a COVID-19 Early Warning System
More sophisticated than the average Apple Watch or Fitbit – which are known for activity monitoring, but only monitor physiological outputs intermittently or with user-initiated point tests – emerging RPM tools continually monitor key physiologic indicators with sufficient sampling and precision to be the basis for accurate detection of changes in health status. These systems need to not only identify that an individual is deviating from their normal health signature, but also be able to identify changes that are unique to COVID-19. These tools have the potential to ultimately supplement or replace symptom and exposure self-reporting to help healthcare providers identify high-risk patients and speed testing.
For example, the World Health Organization (WHO) noted that those who are able to monitor their SpO2 at home have a better chance of identifying the onset of severe pneumonia, which accompanies COVID-19. If SpO2 falls below 93%, the WHO suggests that physicians monitoring this data remotely quickly arrange for inpatient care without requiring the patient to potentially expose others by visiting the emergency room or crowded doctors’ offices.
By tying in high-resolution wearable devices, like advanced smartwatches, for COVID-19 monitoring and management, healthcare providers can identify individuals with possible coronavirus infection earlier. This can help proactively identify individuals at high-risk for complications, as well as test and isolate those who may be asymptomatic – thus, limiting the spread of the diseases. These devices can then be used to detect early signs of deterioration in infected individuals.
With improved insights into physiological changes associated with COVID-19, as well as the individual's exposure profile, providers can proactively identify those who are at high risk. Such early warning signs will provide an upper hand in containing the disease and providing the treatments needed to achieve positive outcomes.
Evaluating the Best Remote Patient Monitoring Solutions
Given the potential of RPM in the fight against COVID-19, a plethora of new solutions are hitting the market. But how do you know if the ones you're considering really work, or are just trying to capitalize during desperate times?
Consider the following when evaluating new COVID-19 RPM tools:
Does it provide COVID-19 specific information? General apps that monitor temperature and respiration aren't necessarily able to detect COVID-19 because they're not specific or sensitive enough. Tools designed specifically for this function should be able to develop biosignatures for the wearer and detect COVID-19 through its active stages.
Is the tool accessible to all? Many wearables are owned by healthy individuals to monitor fitness. But COVID-19 has a bigger impact on populations less likely to invest in such technology – such as the elderly, minorities or low-income individuals.
Will better care result from the data collected? Since use of RPM for COVID-19 is in a nascent stage, there is no definitive proof that these solutions will work. But there is an expectation that tying in automated, continuous biometric data collection with existing health management platforms, electronic health records and risk factors, then applying advanced analytics, will provide greater insights to inform healthcare providers, so they can predict infections before symptoms present and take appropriate actions.
The healthcare sector must explore every weapon in its arsenal to continually fight and control COVID-19. And while technology overall is the key to addressing prevention, containment and recovery, COVID-19 is accelerating innovation across healthcare. Looking to a post-COVID environment, high fidelity wearable devices will become an integral part of health monitoring as virtual care becomes the new norm.
About the Author
Lucienne Marie Ide, M.D., PH.D., is the founder and chair of Rimidi, a cloud-based software platform that enables personalized management of health conditions across populations. She brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, an industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.