Study finds RPM associated with shorter hospital stays, less intensive care use
To perform the study, researchers gave RPM devices to about 9,400 patients from the Froedtert & Medical College of Wisconsin Health Network who tested positive for COVID-19 between March and November 2020. Of those, 5,364 activated the devices. They were asked to track and report their symptoms, temperatures, and pulse oximetry readings for 14 days using either a web or mobile device app. Responses were monitored by a team of Froedtert & Medical College of Wisconsin nurses.
They found that 2.4% of the activated patients were hospitalized within two to 14 days of their test, compared with 3.9% of inactivated patients. The mean length of stay was 2.7 days lower among activated than non-activated patients, and only 0.3% of activated patients had intensive care use versus 1.1% of those who had not activated the program. The unadjusted 90-day mortality rate among activated patients was 0.2%, and 0.6% among activated patients.
The authors offer several possible explanations for RPM’s impact on hospitalization. One is that patients who were being monitored also received education that could have affected their need for hospitalization, such as improving oxygenation through proning.
Another is that doctors caring for activated patients may have felt comfortable not hospitalizing their patients due to the RPM-provided pulse oximetry and nurse support the patients received.
Data from the study also showed that patients who were hospitalized later after titng positive for COVID-19 than those not monitored. The authors offer two possible explanations for the difference. First is that either the patient or the clinician deferred hospitalization because of the services provided through the RPM program. Second is that remote care provided by nurses through the program led to decreased risk and only essential admissions.
The authors say their findings highlight how RPM can be a helpful adjunct to care during the current or future pandemics. “Resource optimization is a central tenet of both RPM and pandemic-era practices,” they note. “If reducing avoidable admissions can be achieved through virtual interventions, then practitioners can focus on in-person care for the most ill patients while also limiting unnecessary contact at hospitals and clinics, which is key to decreasing the spread of COVID-19.”
The study, “Hospitalization Outcomes Among Patients With COVID-19 Undergoing Remote Monitoring” was published July 7 on JAMA Network Open.