MDLife – April 2021
By Samantha Peluso, RN, BSN, Patient & Provider Specialist
It’s one of the great frustrations of the medical profession: although patients look to their physicians for expert guidance, they don’t always follow what’s prescribed. Whether it’s inability to adhere to a schedule or lack of confidence that a difference will be made, patient compliance is often elusive. Until a patient feels truly connected to and in charge of their own health, particularly those with chronic health conditions, there will not be true engagement.
When healthcare providers are able to review patients’ biometric data as frequently as needed between office visits, it makes it easier to detect, diagnose and treat issues. Incorporating RPM in chronic disease management can significantly improve patients’ quality of life by preventing complications and allowing them to maintain independence.
However, data is only useful when it’s submitted consistently. After working with chronic disease patients in their homes to introduce RPM, it is evident to me that many have become accustomed to their own versions of health routines or lack thereof. They slip into bad habits, forgetting to keep track of their measurements or just not believing in the payoff of doing it consistently. Many patients are surprised when they learn just how often they need to be checking their vitals. Some have caregivers at home who are overwhelmed by the daily actions needed. Educating the caregiver as well as the patient is just as important.
Empowering Patients to Manage Their Health
I worked with a lung cancer patient several times over a period of months, integrating RPM tools into the home routine so the patient could monitor oxygen levels and blood pressure and send those vitals to the doctor. No amount of pleading or reasoning from me could overcome the weight of the cancer diagnosis and uncertainty of prognosis, which left this patient feeling hopeless and unwilling to adhere to a daily schedule of monitoring.
I received a call from this patient one day saying they were ready to take control of their life. The latest scans had shown tumors were shrinking and there was no new growth. Hope had been restored, and that’s what it took to finally convince this patient to grab the reins. Now vitals were being checked 4-5 times per week without prompting. SpO2 was being monitored so the doctor would be alerted if an increase was needed, and
weight was being tracked so early detection of fluid buildup would be possible. RPM was now a tool welcomed by the patient to work in partnership with the care team and become engaged with treatment.
Early detection and adjusting treatment
Often patients don’t realize how important it is to record their vitals and send consistent data to their doctor every day. That “light bulb” moment of understanding comes when a patient using RPM sees the connection between monitoring at home and better communication with the doctor.
Another patient was checking blood pressure 3-4 times a week. During an at-home visit, the patient’s blood pressure was low. They continued regular monitoring after that visit and were able to track that it was going up. The doctor received the data and called the patient in for a visit to adjust the medication, bringing blood pressure back down to a normal range. The process worked as it is supposed to, and the patient was able to avoid a possible emergency room visit or more.
Patient compliance may always be a struggle, but RPM is creating more opportunities for patients to see the benefits of communication in action. As they feel more empowered to manage their health, engagement will follow.