By Arik Eisenkraft
For decades, patient blood pressure (BP) has been measured using standardized oscillatory inflatable-cuff monitoring devices.
The measuring process requires a healthcare practitioner to wrap a cuff-based BP monitor around a patient’s upper arm, which then inflates and deflates to manipulate blood flow, creating detectable vibrations within the arteries. These vibrations are then recorded and analyzed to help clinicians understand patient cardiovascular health. For longer monitoring periods, the same process is replicated by automatic BP monitors in the hope that data accumulated over time can reveal more dynamic patient insights or even help identify deterioration. Unfortunately, due to the fact that inflating cuff-based monitors often startles patients and that monitoring BP solely on circumstance as opposed to patient lifestyle can lead to less-than-ideal patient results, these readings do not demonstrate a holistic view of patient heart health.
With advancements in both connectivity and vital-sign tracking capabilities of patient monitoring technologies, wireless wearable remote patient monitoring (RPM) devices unfold new opportunities within the cardiovascular space and healthcare overall. These devices enable us to look at real-time patient data - including BP - unencumbered by cuff-based monitors, allowing clinicians to holistically view patient status, even from a distance.
The power of accurate and continuous remote patient monitoring
A year into the COVID-19 pandemic, healthcare professionals continue to turn to new, innovative RPM devices to prevent unnecessary hospital admissions and limit the spread of the virus. In a recent report, Insider Intelligence estimated that 30 million US patients, or 11.2% of the population, will use RPM tools by 2024—marking 28.2% growth from 23.4 million patients in 2020.
The reasoning behind this growing trend - beyond the remote aspect of these technologies during times of pandemic - is that wearable hospital-grade monitoring devices yield accurate results with minimal involvement from health staff. With regards to BP monitoring, the “white coat effect,” or the alerting reaction to a physician's visit which is known to induce a rise in BP, serves as a primary example of patient results being influenced by in-person vital-sign assessments.
This highlights an additional benefit, in that medical-grade RPM devices allow providers to aggregate patient results over long periods of time without constraining patient lifestyles. This means that vital-sign measurements can be taken and analyzed while patients are eating, walking and sleeping, resulting in accurate readings that properly portray patient health correlating with their actual lifestyle, not only when they have a BP cuff on their arm in a clinician’s office or breaking from their daily activities to self-monitor.
Bringing AI and big data into the mix
With the development of AI and Big Data analysis capabilities, RPM devices play a more pivotal role than ever before within the realm of patient care. In aggregating patient health data from millions of patients, RPM systems can act as guides for clinicians and provide highly attuned patient data insights, helping health professionals care for generic patient populations as well as patients with specific morbidities, including cardiac diseases. By providing precise point of care instruction, RPM systems can alert physicians to patient deterioration and assist in preventing adverse health events.
Answering age-old questions
While the concept of instantaneous results is one that the world has become more accustomed to, the introduction of instantaneous and continuous patient health within the healthcare sphere is truly revolutionary. This culmination of AI insights enabled by Big Data and advanced wearable patient monitoring capabilities has empowered caregivers with patient health insights unlike ever before. Now, clinicians and researchers can fully understand what makes one’s heart work harder, the direct correlation between patient status and medication intake and the health journey that individuals take during the provision of care.
Remote monitoring in the COVID-19 climate
More recently, these capabilities have proven to be crucial in the fight against COVID-19. As hospitals face overflooding and medical personnel experience exhaustion and burnout, the unfortunate reality is that unintentional human error is inevitable. These mistakes can be detrimental to patient outcomes, which is significant when patient conditions are as fragile as they are during COVID-19.
The introduction of wearable RPM devices limits the need for clinicians and nurses to spot-check patients and monitor their vitals, helping to mitigate viral exposure and spread. RPM systems also serve as a useful tool in discovering deeper patient nuances of COVID-19, allowing providers and scientists to seamlessly conduct studies on the impact of the pandemic in remote care settings, including the home. These RPM systems also offer opportunities for pharmaceutical companies and CROs to conduct decentralized clinical trials, which may become the new normal as we move forward into a post COVID-19 era.
With all of this in mind, it is time for antiquated patient monitoring methods, like cuff-based BP monitors, to take a back seat to new and improved AI-powered wearable RPM systems. By providing truly holistic, accurate and reliable patient health data, these devices are changing the scope of patient monitoring throughout the turbulent COVID-19 climate and beyond, offering a new dimension into the world of patient care based on real-time data from real life activity. As we look ahead, we can be excited at the prospect of RPM systems elevating the standard of patient care and becoming the standard of patient monitoring, especially BP, in hospitals and in the home.
About the author: Prof. Arik Eisenkraft, MD, MHA is the Chief Medical Officer of Biobeat, developer of wearable AI-powered remote patient monitoring solutions.