The Next Frontier of Remote Patient Monitoring: Hospital at Home

Area of Science:

• Digital Health
• Healthcare Management
• Patient Care Technology

Background:

• Hospital at Home (HaH) offers safe, efficient remote care for chronic conditions but faces limited adoption.
• Current HaH models often restrict patient eligibility due to infrequent vital sign monitoring.
• Remote Patient Monitoring (RPM) presents an opportunity to expand HaH's reach and benefits.

Purpose of the Study:

• To explore the potential of RPM modalities in enhancing the Hospital at Home (HaH) model.
• To identify how RPM can increase patient eligibility, improve safety, and reduce costs within HaH.
• To highlight the benefits of integrating vital sign, ECG, and fall monitoring into HaH.

Main Methods:

• Review of current HaH practices and limitations in patient eligibility.
• Analysis of three primary RPM modalities: vital sign, continuous single-lead ECG, and fall monitoring.
• Case experience from Massachusetts General Hospital on expanding HaH enrollment with RPM.

Main Results:

• RPM, particularly vital sign monitoring, can expand HaH eligibility to moderate-acuity patients.
• Continuous ECG monitoring can increase enrollment for specific conditions like heart failure.
• Fall detection RPM enhances patient safety and aids in post-discharge fall mitigation.

Conclusions:

• RPM integration significantly increases HaH patient eligibility and safety.
• RPM adoption can lead to greater economies of scale and reduced costs for HaH programs.
• Further research into operational, technical, and policy aspects is needed to fully realize RPM's potential in HaH.