Telemedicine: Remote Patient Monitoring

Remote patient monitoring uses devices to remotely collect, store and communicate biometric health information to practitioners. The technology allows health care providers to accurately monitor and intervene in the patient’s care before he presents at the doctor’s office or hospital. The field capitalizes on two trends in the health care marketplace—proactive care and patient mobility.

MedApps, a market leader, understands the benefits of this technology. Chief Executive Officer Kent Dicks notes that a connected patient is more compliant, more likely to conform to doctors’ orders, more inclined to take his medications and, as a result, stay out of the hospital.

MedApps produces a line of remote monitoring solutions including HealthPAL and HealthAIR, dedicated cellular devices that can be used wherever the patient is located. The technology communicates with retail medical devices—such as glucose meters, blood pressure monitors, scales and pulse oximeters—through wireless Bluetooth technology or a wired USB connection. MedApps’ devices collect data from these monitors and automatically upload the information to the patient’s EHR in the cloud via machine-to-machine cellular technology. The health care practitioner can view the data online, in his chosen application and export reports in various file formats.

MedApps’ technology is store-and-forward, but it can send data in near real-time. The parameters of monitoring (i.e. how often readings are taken, acceptable range levels, etc.) are defined by the patient’s care provider based on the disease treatment plan. In most cases, the doctor is reviewing the data for trends for chronic conditions such as diabetes and hypertension, so real-time transmission is not crucial, rather it’s the accuracy and consistency of the data. MedApps expects remote monitoring technology to further evolve over time as these solutions are universally adopted and utilized for more complicated medical conditions.

Dicks envisions a line of plug-and-play mobile health devices. “In the future, you’ll be able to walk down an ‘eCare’ aisle in your local pharmacy or big-box store and pick up any number of monitoring solutions at various price points and levels of mobility,” Dicks said. “The full spectrum of monitoring devices will be available, from a fully automated, wireless HealthPal, to a lower cost USB-connected HealthAIR. Other solutions such as a kiosk system can fill in the gaps, allowing the user to collect and store health data remotely, until they visit a kiosk location and transmit the info to their doctor. These kiosks can be publicly available, anywhere from your local shopping mall and Wal-Mart to truck-stops.”

The technology has widespread applicability. “If a device collects health data, theoretically it could send it back remotely to be monitored at a central repository,” Dicks said.  “For instance, fetal monitors could be installed in patient’s homes to monitor for SIDS, sudden infant death syndrome. In my home state of Arizona, half of the schools don’t have nurses. With remote technology you could monitor a child’s health status and send the information back to his parents.”

“The same technology could be integrated into implantable devices—defibrillators, pacemakers, insulin pumps—alerting the patient and his caregivers as changes in condition arise,” Dicks continued. “As the baby boomers age, the elderly will benefit from mobile personal emergency response systems (PERS), another type of monitoring device which could also enable GPS location and two-way voice conversation.”

Dicks acknowledges that these are long-range ideas. Remote patient monitoring is very much a nascent market. Consumers are uninformed about the technology and not yet willing to pay for the services. Likewise, most doctors cannot receive reimbursement from insurance companies for remote care devices—but with health care reform, this all may change.

“Health care reform is bending the cost curve and mandating that practitioners do more with less,” Dicks said. “In the future, the insurer will provide the doctor with a set price to care for a patient’s illness or injury. It will be in the doctor’s financial best interest to ensure that the patient is compliant with orders, and to put processes in place to keep the patient in good health.”

MedApps and its competitors are targeting patients who suffer from acute, chronic conditions such as congestive heart failure, hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and asthma. “MedApps estimates that the mHealth eCare market stands at 20-40 million people, and this is a conservative estimate.” Dicks said. “Wireless home health has seen significant growth in recent years; the U.S. market is anticipated to top $4.4 billion by 2013, according to a recent Parks & Associates report. Although it’s too early to accurately forecast the market size, this is clearly a booming segment that holds great promise for health care practitioners, patients and communications providers, which provide the connectivity for these devices.”[1]

Telecommunications providers are at the heart of the remote monitoring value chain, providing the connectivity for the device, the trusted link between the patient and his caregiver. Perhaps there is a role for rural telcos in the remote monitoring marketplace, beyond providing broadband connectivity and patent device support. Rural local exchange carriers (RLECs) also may consider operating remote monitoring data centers, which collect the data from patient devices and transmit it to health care providers via a common electronic health record (EHR) format.  Telcos also may investigate call center services, which upon receiving critical patent data, immediately contact the health care provider.

Technology Partners

The national health care ecosystem is under increasing pressure to reduce costs, minimize errors and provide quality care. Technology can help to address these challenges. Broadband applications enable practitioners to more efficiently and efficiently service the patient. Broadband technology also can help to bridge the gap between health care availability and patient need. Although health information technology (HIT) is not a new concept, the federal government has only recently recognized the importance of HIT to the future of patient care, committing to removing restrictions to its use and encouraging providers to adopt new technologies.

Health care providers are looking for trusted technology partners who can provide IT education, connect their facilities with cutting-edge telecommunications connectivity, and support their ongoing technology needs. Rural broadband providers should consider proactively approaching health care providers in their service territories to inquire about their technology preparation and future requirements.

[1] Parks Associates, “Wireless Healthcare: Analysis & Forecasts,” August 2009,–4-billion-industry-by-2013- (last visited July 13, 2011). Also see MobiHealthNews, “mHealth predictions: $1.9B, $4.4B, $4.6B?,” April 14, 2010, (last visited July 13, 2011).

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