Remote access: From COVID to chronic conditions, patient monitoring tech is helping hospitals keep patients home

When it comes to technology being deployed at hospitals, health care leaders are most excited about the tools that keep patients out of them.

Dr. Lina Shihabuddin, chief medical officer for the primary care service line at RWJBarnabas-Rutgers Medical Group, is one of the industry’s many new believers in remote patient monitoring — technology tools that can track patient data outside of standard health care settings.

“This technology allows us to keep patients cared for at home by loved ones instead of isolated in hospital beds,” she said. “And the best care is at home — favorite meals are prepared, they’re not exposed to other people who are sick and they’re not isolated.”

Remote patient monitoring, a subset of the telehealth trend in health care technology, took center stage for the industry as local surges of COVID-19 case put a spotlight on how capacity-strained a hospital could become.

“The need to monitor patients during their COVID-19 course at home became essential for us quickly as we ran out of observation beds,” Shihabuddin said. “We needed to send people home, sometimes after an emergency room visit or hospital stay, but still monitor oxygen levels and other vitals.”

In the early months of the pandemic, even a medical group associated with the state’s largest health system, RWJBarnabas Health, lacked all the equipment it needed to do large-scale remote monitoring of patients.

In March of last year, Shihabuddin said her group was scrambling to get as many pulse oximeters as it could, having to collect a dozen from one medical device supplier, another dozen elsewhere — cobbling together enough equipment to feel comfortable sending patients home with the ability to check their oxygen saturation levels.

After being awarded a grant from the Federal Communications Commission — an opportunity afforded through the CARES Act — the group acquired 300 new home monitoring kits that allowed medical care teams to not only remotely monitor oxygen saturation, but blood pressure and other vital signs.

Shihabuddin said the use of these monitoring devices did present something of a logistical challenge: How do you get these devices to a patient with an active COVID-19 infection at home?

“We had to develop workflows, not only get (these tools) in their hands, but how to get it back and sterilize it for the next person,” she said. “There’s an army of people who do that. We work with a company that drops off devices and attachments in a box outside of the home, and then they bring it back and clean it and replace a lot of the parts to sanitize it.”

The devices are starting to be deployed not only for COVID-19 care at home, but for patients who normally would come in to their doctor’s office at least once a month for the management of other conditions, Shihabuddin added. Monitoring kits also can facilitate at-home electrocardiograms and help medical providers assess fall-risk data.

Amy Mansue. (File photo)

Amy Mansue, CEO and president of Woodbury-based Inspira Health, said home monitoring comes with a lot of utility for patients with chronic disease — not only patients with acute problems that need to be monitored before emergency medical intervention is needed.

“With a patient who has (heart failure), you want to watch for filling of the lungs with fluid very carefully, so they don’t end up coming back to the hospital, or what their weight is, whether they’re staying on their (medicines) or eating correctly to keep their chronic disease in check,” she said. “With COVID, hospital beds are at a premium.”

And, until late last year, there were no visitations permitted at New Jersey hospitals, until the New Jersey Hospital Association and local hospitals partnered to create a standardized policy.

“That lack of visitation has been very difficult, and we’re just beginning to understand the ramifications of separating people from their loved ones during this time,” Mansue said. “It’s for the public’s safety, but it can also be emotionally damaging for patients and loved ones.”

Shihabuddin agrees that’s been one of the most important aspects of having new remote patient monitoring options.

“It’s one of the reasons that what we’ve learned from COVID-19 and how quickly we’ve had to respond to it is that home care is often the best care,” she said. “As much as we can keep patients at home, even after COVID, this is something we should be doing.”