Association Between Weight Loss and Glycemic Outcomes: A Post Hoc Analysis of a Remote Patient Monitoring Program for Diabetes Management

2020 ◽  
Vol 26 (5) ◽  
pp. 621-628 ◽  
Author(s):  
Tzeyu L. Michaud ◽  
Mohammad Siahpush ◽  
Paul Estabrooks ◽  
Robert J. Schwab ◽  
Tricia D. LeVan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Patient Monitoring ◽  
Diabetes Management ◽  
Monitoring Program ◽  
Remote Patient Monitoring ◽  
Post Hoc Analysis ◽  
Remote Patient ◽  
Glycemic Outcomes ◽  
Post Hoc

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

2020 ◽  
Vol 159 ◽  
pp. 107944
Author(s):  
Tzeyu L. Michaud ◽  
Mohammad Siahpush ◽  
Keyonna M. King ◽  
Athena K. Ramos ◽  
Regina E. Robbins ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Patient Monitoring ◽  
Diabetes Management ◽  
Monitoring Program ◽  
Program Completion ◽  
Remote Patient Monitoring ◽  
Remote Patient

Understanding the Effects of Participation in a Large-scale Remote Diabetes Monitoring Program: A Qualitative Survey and Retrospective Analysis Study (Preprint)

2021 ◽  
Author(s):  
Yee Chieh Chew ◽  
Michael Swiernik ◽  
Thomas McCormick ◽  
Angie Stevens
Keyword(s):  
Health Outcomes ◽  
Care Management ◽  
Patient Monitoring ◽  
Monitoring Program ◽  
Care Providers ◽  
Remote Patient Monitoring ◽  
Kaiser Permanente ◽  
Program Adherence ◽  
Remote Patient ◽  
Diabetic Care

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.

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

2019 ◽  
Vol 25 (10) ◽  
pp. 952-959 ◽  
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

scholarly journals Rapid implementation of a COVID-19 remote patient monitoring program

2020 ◽  
Vol 27 (8) ◽  
pp. 1326-1330 ◽  
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.

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

2019 ◽  
Vol 39 (5) ◽  
pp. 472-478 ◽  
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.

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

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.

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

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.

MO029CLINICAL AND SOCIAL ADVANTAGES OF REMOTE PATIENT MONITORING IN HOME DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Massimo Morosetti ◽  
Maria Iolanda Famà
Keyword(s):  
Quality Of Life ◽  
Remote Monitoring ◽  
Patient Monitoring ◽  
Diastolic Pressure ◽  
Monitoring Program ◽  
Systolic Pressure ◽  
Remote Patient Monitoring ◽  
Home Dialysis ◽  
Remote Patient

Abstract Background and Aims Home dialysis (both extracorporeal and peritoneal) can improve the management and the quality of life of patients affected by end stage renal disease. Remote patient monitoring (RPM) can improve the care of Patients in home dialysis: RPM may detect early problems, ensure compliance and give both clinicians and patients a sense of reassurance regarding the clinical management. These advantages may translate into improved outcomes and increased uptake on home dialysis therapies. For these reasons, the Doctor Plus® NEPHRO program has been created. Clinical and social advantages derived from remote patient monitoring by the Doctor Plus® NEPHRO program versus the standard of care were evaluated. Method Patients included in the remote monitoring program, by the Nephrology Unit of ASL 3 in Rome (Italy), from July 2017 and April 2019, were analyzed. Each patient was observed for at least 4 months, up to 22 months. Patients received a Doctor Plus® NEPHRO KIT composed by clinical devices to measure systolic and diastolic pressure, heart rate, body weight and oximetry. Clinical data were automatically sent from electronic devices to the HUB included into the provided KIT and from the HUB to the Vree Platform operating at the Nephrology Unit. All devices, included HUB and Vree Platform, were classified as medical device class IIa. The SF-12 questionnaire was also administered by remote nurses and the level of satisfaction with the program Doctor Plus® NEPHRO was evaluated. Results We observed 16 patients (56,3% males, mean age 62 years), 14 in Peritoneal Dialysis and 2 in Home Hemodialysis. A total number of 35.720 clinical measures were collected during the observational period. During this length time, systolic pressure was reduced in 69% of patients and diastolic pressure was reduced in 62,5% of patients. Systolic pressure decreased from 137,8 to 130,2 mmHg (p<0,0002) and diastolic pressure decreased from 80,5 to 76 mmHg (p>0,0002). Mean heart rate decreased in 50% of patients from 69,4 bpm to 68,8 bpm (p<0,0046). During the same period, clinical monitoring generated 58 early clinical interventions: 11 non planned visits at Nephrological Centre and 47 calls from nephrologist to patients (0,5 visits per month and 2,2 calls per month). In 35 cases pharmacological therapy has been modified (in 80% of cases treatment modified was the hypertension therapy). Due to the increase of clinical monitoring, Patients accesses to ER are decreased of 29%. SF-12 questionnaire showed an improvement in the perceived health status in all patients. Reduction of 15% in workdays lost were registered in both patients and caregivers. Conclusion Doctor Plus® NEPHRO resulted as a useful tool for the Nephrology Center in order to monitor patients who performed home dialysis. Data collected by the remote monitoring program have shown an improvement in clinical outcomes and the possibility to prevent some clinical complications thus reducing clinical emergencies and the hospitalization rate. Moreover, the possibility for patients and caregivers to complain with morbidity remaining in a home setting, results in the improvement in quality of life. Finally, the possibility to avoid hospitalizations, emergency accesses and transfers to hemodialysis is important for cost saving with a more appropriate use of healthcare resources.

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