Program completion and glycemic control in a remote patient monitoring program for diabetes management: Does gender matter?

BACKGROUND Remote patient monitoring has shown promise in helping management of population health by facilitating care management between providers and patients by providing real-time accurate data of relevant readings for chronic conditions from outside a medical facility. Kaiser Permanente offers remote patient monitoring as part of a holistic care management program for its members. OBJECTIVE The purpose of this study was to examine qualitative and quantitative measures of patient and provider feedback of Kaiser Permanente’s remote patient monitoring program for diabetes, patient perspectives on ability to manage diabetic care, patient health outcomes and program adherence, and utilization of Kaiser Permanente services under the program. METHODS In this study, patients who were enrolled in the RPM program in Southern California from 2017 onwards as well as care providers who had enrolled at least one patient in the program were studied. For qualitative data, online surveys were deployed. For quantitative analysis, clinical and demographic data drawn from existing data systems, which included Kaiser Permanente membership records, encounter records, electronic medical records, and administrative data repositories were used. RESULTS Providers (N=160) and patients (N=1,106) responded to the survey and reported many qualitative benefits from participating in the study, including improved coordination of clinical care and increased accountability. Patients who were enrolled in the program experienced a mean decrease of 1.25 in HbA1c results and an increase in encounters over 90 days which gradually come back to pre-enrollment encounter levels around 6 months. Those who actively upload glucose readings met the program upload goals within the first month a majority (92%) of the time. CONCLUSIONS There are many qualitative benefits for patients and providers incorporating Kaiser Permanente’s remote patient monitoring program as part of diabetic care. The quantitative descriptions of health outcomes, service utilization, and program adherence speak to the feasibility and value of deploying remote monitoring tools at scale within healthcare organizations.

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Diabetes Management Through Remote Patient Monitoring: The Importance of Patient Activation and Engagement with the Technology

Telemedicine Journal and e-Health ◽

10.1089/tmj.2018.0205 ◽

2019 ◽

Vol 25 (10) ◽

pp. 952-959 ◽

Cited By ~ 7

Author(s):

Dejun Su ◽

Tzeyu L. Michaud ◽

Paul Estabrooks ◽

Robert J. Schwab ◽

Leslie A. Eiland ◽

...

Keyword(s):

Patient Monitoring ◽

Diabetes Management ◽

Patient Activation ◽

Remote Patient Monitoring ◽

Remote Patient

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Rapid implementation of a COVID-19 remote patient monitoring program

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocaa097 ◽

2020 ◽

Vol 27 (8) ◽

pp. 1326-1330 ◽

Cited By ~ 14

Author(s):

Tucker Annis ◽

Susan Pleasants ◽

Gretchen Hultman ◽

Elizabeth Lindemann ◽

Joshua A Thompson ◽

...

Keyword(s):

Patient Monitoring ◽

Hospital Admissions ◽

Education Technology ◽

Monitoring Program ◽

Remote Patient Monitoring ◽

Emergency Room Visits ◽

Educational Materials ◽

Virtual Care ◽

Remote Patient ◽

Technology Solution

Abstract Objective The study sought to evaluate early lessons from a remote patient monitoring engagement and education technology solution for patients with coronavirus disease 2019 (COVID-19) symptoms. Materials and Methods A COVID-19–specific remote patient monitoring solution (GetWell Loop) was offered to patients with COVID-19 symptoms. The program engaged patients and provided educational materials and the opportunity to share concerns. Alerts were resolved through a virtual care workforce of providers and medical students. Results Between March 18 and April 20, 2020, 2255 of 3701 (60.93%) patients with COVID-19 symptoms enrolled, resulting in over 2303 alerts, 4613 messages, 13 hospital admissions, and 91 emergency room visits. A satisfaction survey was given to 300 patient respondents, 74% of whom would be extremely likely to recommend their doctor. Discussion This program provided a safe and satisfying experience for patients while minimizing COVID-19 exposure and in-person healthcare utilization. Conclusions Remote patient monitoring appears to be an effective approach for managing COVID-19 symptoms at home.

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Remote Patient Monitoring Program in Automated Peritoneal Dialysis: Impact on Hospitalizations

Peritoneal Dialysis International ◽

10.3747/pdi.2018.00287 ◽

2019 ◽

Vol 39 (5) ◽

pp. 472-478 ◽

Cited By ~ 10

Author(s):

Mauricio Sanabria ◽

Giancarlo Buitrago ◽

Bengt Lindholm ◽

Jasmin Vesga ◽

Lars-Göran Nilsson ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Propensity Score ◽

Propensity Score Matching ◽

Patient Monitoring ◽

Negative Impact ◽

Monitoring Program ◽

Remote Patient Monitoring ◽

Automated Peritoneal Dialysis ◽

Remote Patient ◽

Hospital Days

Background Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients’ adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy. Methods A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days. Results After propensity score matching, APD therapy with RPM ( n = 63) compared with APD-without RPM ( n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 – 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 – 0.92]; p = 0.028). Conclusions The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.

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467-P: Immediate and Sustained Trends in Glycemic Control during Remote Patient Monitoring in People with Type 2 Diabetes

Diabetes ◽

10.2337/db21-467-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 467-P

Author(s):

TONG SHENG ◽

SARINE BABIKIAN ◽

VIKRAM SINGH ◽

MARK A. CLEMENTS

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Patient Monitoring ◽

Remote Patient Monitoring ◽

Remote Patient

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Cost analysis of a remote patient monitoring programme for post-discharge patients with type 2 diabetes

Journal of Telemedicine and Telecare ◽

10.1177/1357633x20985393 ◽

2021 ◽

pp. 1357633X2098539

Author(s):

Tzeyu L Michaud ◽

Jennie L Hill ◽

Paul A Estabrooks ◽

Dejun Su

Keyword(s):

Type 2 Diabetes ◽

Cost Analysis ◽

Patient Monitoring ◽

Diabetes Management ◽

Economic Feasibility ◽

Remote Patient Monitoring ◽

Post Discharge ◽

Scenario Analyses ◽

Remote Patient

Introduction Assessing costs of an evidence-based health promotion programme is crucial to understand the economic feasibility of adopting or sustaining the programme. This study conducted a cost analysis of a remote patient monitoring (RPM) programme to enhance the post-discharge management of type 2 diabetes. Methods Using retrospective data collected during RPM implementation from September 2014 to February 2018, we estimated the costs of implementing an RPM in the primary care setting. Measures included total and average annual costs, costs per participant who was enrolled or completed the programme, and costs per person-day. We further conducted sensitivity and scenario analyses to examine variations in estimated programme costs associated with varying programme efficiencies and alternative personnel compositions of the RPM team. Results The total RPM implementation costs were estimated at US$4,374,544 with an average annual programme costs of US$1,249,870, which translated to US$3207 per participant ( n = 1364) completing the three-month programme. The per person-day cost was averaged at US$24 (182,932 person-days). Sensitivity and scenario analyses results indicate that the sustainment costs were approximately US$1.6 million annually and the per-person-day costs were between US$21 and US$29 with each nurse coach on average serving a panel of 62–93 patients. Conclusion The implementation and sustainment costs of an RPM programme, estimated under various assumptions of programme efficiency and care team compositions, as exemplified in this study, will help healthcare organizations make informed decisions in budgeting for and sustaining telehealth programmes to enhance diabetes management.

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Technique failure in remote patient monitoring program in patients undergoing automated peritoneal dialysis: A retrospective cohort study

Peritoneal Dialysis International ◽

10.1177/0896860820982223 ◽

2020 ◽

pp. 089686082098222

Author(s):

Leyder Corzo ◽

Martin Wilkie ◽

Jasmin I Vesga ◽

Bengt Lindholm ◽

Giancarlo Buitrago ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Failure Rate ◽

Patient Monitoring ◽

Monitoring Program ◽

P Value ◽

Remote Patient Monitoring ◽

Automated Peritoneal Dialysis ◽

Remote Patient ◽

Technique Failure

Background: Remote patient monitoring (RPM) programs in automated peritoneal dialysis (APD) allow clinical teams to be aware of many aspects and events of the therapy that occur in the home. The present study evaluated the association between RPM use and APD technique failure. Methods: A retrospective, multicentre, observational cohort study of 558 prevalent adult APD patients included between 1 October 2016 and 30 June 2017 with follow-up until 30 June 2018 at Renal Therapy Services network in Colombia. Patients were divided into two cohorts based on the RPM use: APD-RPM ( n = 148) and APD-without RPM ( n = 410). Sociodemographic and clinical characteristics of all patients were summarized descriptively. A propensity score was used to create a pseudo-population in which the baseline covariates were well balanced. The association of RPM with technique failure was estimated adjusting for the competing events death and kidney transplant. Results: Five hundred fifty-eight patients were analyzed. 26.5% had APD-RPM. In the matched sample comprising 148 APD-RPM and 148 APD-without RPM patients, we observed a lower technique failure rate of 0.08 [0.05–0.15] episodes per patient-year in APD-RPM versus 0.18 [0.12–0.26] in APD-without RPM cohort; incidence rate ratio = 0.45 95% confidence interval: [0.22–0.91], p-value = 0.03. Conclusions: The use of an RPM program in APD patients may be associated with a lower technique failure rate. More extensive and interventional studies are needed to confirm its potential benefits and to measure other patient-centered outcomes.

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