scholarly journals A Remote Patient Monitoring Intervention for Patients With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Pre-Post Economic Analysis of the Smart Program (Preprint)

2018 ◽  
Author(s):  
Wanrudee Isaranuwatchai ◽  
Olwen Redwood ◽  
Adrian Schauer ◽  
Tim Van Meer ◽  
Jonathan Vallée ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Patient Monitoring ◽  
Chronic Obstructive ◽  
Remote Patient Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Study Population ◽  
Remote Patient ◽  
Care Costs

BACKGROUND Exacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are associated with high health care costs owing to increased emergency room (ER) visits and hospitalizations. Remote patient monitoring (RPM) interventions aim to improve the monitoring of symptoms to detect early deterioration and provide self-management strategies. As a result, RPM aims to reduce health resource utilization. To date, studies have inconsistently reported the benefits of RPM in chronic illnesses. The Smart Program is an RPM intervention that aims to provide clinical benefit to patients and economic benefit to health care payers. OBJECTIVE This study aims to economically evaluate the potential benefits of the Smart Program in terms of hospitalizations and ER visits and, thus, associated health care costs from the perspective of the public health care system. METHODS Seventy-four patients diagnosed with COPD or CHF from one hospital site were included in this one-group, pre-post study. The study involved a secondary data analysis of deidentified data collected during the study period – from 3 months before program initiation (baseline), during the program, to 3 months after program completion (follow-up). Descriptive analysis was conducted for the study population characteristics at baseline, the clinical frailty score at baseline and 3-month follow-up, client satisfaction at 3-month follow-up, and number and costs of ER visits and hospitalizations throughout the study period. Furthermore, the cost of the Smart Program over a 3-month period was calculated from the perspective of the potential implementer. RESULTS The baseline characteristics of the study population (N=74) showed that the majority of patients had COPD (50/74, 68%), were female (42/74, 57%), and had an average age of 72 (SD 12) years. Using the Wilcoxon signed-rank test, the number of ER visits and hospitalizations, including their associated costs, were significantly reduced between baseline and 3-month follow-up (P<.001). The intervention showed a potential 68% and 35% reduction in ER visits and hospitalizations, respectively, between the 3-month pre- and 3-month postintervention period. The average cost of ER visits reduced from Can $243 at baseline to Can $67 during the 3-month follow-up, and reduced from Can $3842 to Can $1399 for hospitalizations. CONCLUSIONS In this study, the number and cost of ER visits and hospitalizations appeared to be markedly reduced for patients with COPD or CHF when comparing data before and after the Smart Program implementation. Recognizing the limitations of the one-group, pre-post study design, RPM requires an upfront investment, but it has the potential to reduce health care costs to the system over time. This study represents another piece of evidence to support the potential value of RPM among patients with COPD or CHF.

scholarly journals Remote Patient Monitoring Technologies for Predicting Chronic Obstructive Pulmonary Disease Exacerbations: Review and Comparison (Preprint)

2019 ◽  
Author(s):  
Kathleen G Fan ◽  
Jess Mandel ◽  
Parag Agnihotri ◽  
Ming Tai-Seale
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Patient Monitoring ◽  
Product Information ◽  
Ease Of Use ◽  
Chronic Obstructive ◽  
Remote Patient Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Remote Patient

BACKGROUND Chronic obstructive pulmonary disease (COPD) is the third leading cause of death by disease worldwide and has a 30-day readmission rate of 22.6%. In 2015, COPD was added to the Medicare Hospital Readmission Reductions Program. OBJECTIVE The objective of this paper was to survey the current medical technologies for remote patient monitoring (RPM) tools that forecast COPD exacerbations in order to reduce COPD readmissions. METHODS We searched literature and digital health news to find commercially available RPM devices focused on predicting COPD exacerbations. These technologies were reviewed and compared according to four criteria: forecasting ability, cost, ease of use, and appearance. A rating system was developed to facilitate the evaluation process. RESULTS As of June 2019, a list of handheld and hands-free devices was compiled. We compared features and found substantial variations. Devices that ranked higher on all criteria tended to have a high or unlisted price. Commonly mass-marketed devices like the pulse oximeter and spirometer surprisingly fulfilled the least criteria. CONCLUSIONS The COPD RPM technologies with most technological promise and compatibility with daily living appear to have high or unlisted prices. Consumers and providers need better access to product information to make informed decisions.

scholarly journals Overlap of Asthma and Chronic Obstructive Pulmonary Disease in Patients in the United States: Analysis of Prevalence, Features, and Subtypes (Preprint)

2018 ◽  
Author(s):  
Ralph Turner ◽  
Michael DePietro ◽  
Bo Ding
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Medical Record ◽  
Health Care Costs ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Medication Utilization ◽  
Care Costs

BACKGROUND Although asthma and chronic obstructive pulmonary disease (COPD) are clinically distinct diseases, they represent biologically diverse and overlapping clinical entities and it has been observed that they often co-occur. Some research and theorizing suggest there is a common comorbid condition termed asthma-chronic obstructive pulmonary disease overlap (ACO). However, the existence of ACO is controversial. OBJECTIVE The objective of this study is to describe patient characteristics and estimate prevalence, health care utilization, and costs of ACO using claims-based diagnoses confirmed with medical record information. METHODS Eligible patients were commercial US health plan enrollees; ≥40 years; had asthma, COPD, or ACO; ≥3 prescription fills for asthma/COPD medications; and ≥2 spirometry tests. Records for a random sample of 5000 patients with ACO were reviewed to validate claims-based diagnoses. RESULTS The estimated ACO prevalence was 6% (estimated 10,250/183,521) among 183,521 full study patients. In the claims-based cohorts, the comorbidity burden for ACO was greater versus asthma but similar to COPD cohorts. Medication utilization was higher in ACO versus asthma and COPD. Mean total health care costs were significantly higher for ACO versus asthma but similar to COPD. In confirmed diagnoses cohorts, mean total health care costs (medical plus pharmacy) were lower for ACO versus COPD but similar to asthma (US $20,035; P=.56). Among confirmed cases, where there was medical record evidence, smoking history was higher in ACO (300/343, 87.5%) versus asthma cohorts (100/181, 55.2%) but similar to COPD (68/84, 81%). CONCLUSIONS ACO had more comorbidities, medication utilization, and costs than patients with asthma or COPD but differences were not seen after confirmation with medical records.

scholarly journals Remote Patient Monitoring Technologies for Predicting Chronic Obstructive Pulmonary Disease Exacerbations: Review and Comparison

10.2196/16147 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e16147 ◽  
Author(s):  
Kathleen G Fan ◽  
Jess Mandel ◽  
Parag Agnihotri ◽  
Ming Tai-Seale
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Patient Monitoring ◽  
Product Information ◽  
Ease Of Use ◽  
Chronic Obstructive ◽  
Remote Patient Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Remote Patient

Background Chronic obstructive pulmonary disease (COPD) is the third leading cause of death by disease worldwide and has a 30-day readmission rate of 22.6%. In 2015, COPD was added to the Medicare Hospital Readmission Reductions Program. Objective The objective of this paper was to survey the current medical technologies for remote patient monitoring (RPM) tools that forecast COPD exacerbations in order to reduce COPD readmissions. Methods We searched literature and digital health news to find commercially available RPM devices focused on predicting COPD exacerbations. These technologies were reviewed and compared according to four criteria: forecasting ability, cost, ease of use, and appearance. A rating system was developed to facilitate the evaluation process. Results As of June 2019, a list of handheld and hands-free devices was compiled. We compared features and found substantial variations. Devices that ranked higher on all criteria tended to have a high or unlisted price. Commonly mass-marketed devices like the pulse oximeter and spirometer surprisingly fulfilled the least criteria. Conclusions The COPD RPM technologies with most technological promise and compatibility with daily living appear to have high or unlisted prices. Consumers and providers need better access to product information to make informed decisions.

scholarly journals Tele-Healthcare Unit for Remote Patient Monitoring

2019 ◽  
Vol 9 (2) ◽  
pp. 2902-2904
Keyword(s):  
Health Care ◽  
Patient Monitoring ◽  
Care Patient ◽  
Health Administration ◽  
Remote Patient Monitoring ◽  
Normal Range ◽  
Long Distance ◽  
Health Care Unit ◽  
Professional Health ◽  
Remote Patient

Tele-health is characterized as the usage of electronic data and broadcast using telecommunication advancements to help and advance long-distance clinical medicinal services, patient and expert long-distance clinical health care, patient and professional health education, public healthmonitoring and health administration. In this research, the proposed system that uses Sensors to monitor patient's health and uses internet to alert the practitioner and family members in case of emergency. It is capable of monitoring health status of the patient at home, which is at remote location also. If system identifies any parameter is beyond the normal range temperature, the health care unit gives continuous alertation about the patients’ status over Internet and also shows details of heartbeat & temperature of patient continuously using the IoT.

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