Telehealth: remote monitoring of patients

The ability to monitor certain aspects of patients’ health from their home has become an increasingly popular telehealth option that have been accelerated by the COVID-19 pandemic¹. Generally, telehealth spans from simple video calls between patients and doctors replacing routine visits to complex remote monitoring of general health or specific disease related parameters. Interestingly, telehealth as such have been shown to cut down on patients’ travel costs² and infection risk at hospitals or in the GPs office³. But the overall health benefits are debated and a recent review of 29 studies utilizing remote monitoring in COPD care concluded that no important benefits for patients were obtained, neither looking at symptoms nor quality of life⁴. However, people who were monitored through telehealth technology and usual care had some reduction in risk of hospital re-admission⁴.

In COPD and asthma care, remote monitoring can largely be categorized based on the purpose of the monitoring:

1. To predict or foresee flare ups by collecting health and disease parameters. This kind of monitoring is usually associated with simple monitoring such as QoL questionaries and health parameters as body temperature which is report digitally and monitored by nurses or potentially AI.
2. To improve patient awareness of changes in symptoms by recording in digital diaries or mobile applications and thus realize potential triggers, which may lead to improved self-management.
3. To improve care by increasing treatment adherence and or compliance, which usually involves the use of smart inhalers or add-on modules in connection with a mobile application displaying the data for the patient.

Despite the development of various digital tools such as mobile applications, smart inhalers, and smart add-on modules, a general implementation of these remains a challenge due to complexities in the use and the relative high cost that patients are reluctant to pay⁵. The cost related to remote monitoring and associated increased workload of analysing reports need to be studied to show that the use of these is cost effective, providing better disease control and improved quality of life for patients⁵.

Thus, having the purpose in mind when trying to identify patients where remote monitoring can add value seems to be key –when it comes to remote monitoring of patients there is no one size fits all!