Coffey Jordan D, Christopherson Laura A, Williams Ryan D, Gathje Shelby R, Bell Sarah J, Pahl Dominick F, Manka Lukas, Blegen R Nicole, Maniaci Michael J, Ommen Steve R, Haddad Tufia C
Center for Digital Health, Mayo Clinic, Rochester, MN, United States.
Integrity & Compliance Office, Mayo Clinic, Rochester, MN, United States.
Front Digit Health. 2022 Dec 14;4:1052408. doi: 10.3389/fdgth.2022.1052408. eCollection 2022.
Numerous factors are intersecting in healthcare resulting in an increased focus on new tools and methods for managing care in patients' homes. Remote patient monitoring (RPM) is an option to provide care at home and maintain a connection between patients and providers to address ongoing medical issues.
Mayo Clinic developed a nurse-led RPM program for disease and post-procedural management to improve patient experience, clinical outcomes, and reduce health care utilization by more directly engaging patients in their health care. Enrolled patients are sent a technology package that includes a digital tablet and peripheral devices for the collection of symptoms and vital signs. The data are transmitted from to a hub integrated within the electronic health record. Care team members coordinate patient needs, respond to vital sign alerts, and utilize the data to inform and provide individualized patient assessment, patient education, medication management, goal setting, and clinical care planning.
Since its inception, the RPM program has supported nearly 22,000 patients across 17 programs. Patients who engaged in the COVID-19 RPM program experienced a significantly lower rate of 30-day, all-cause hospitalization (13.7% vs. 18.0%, = 0.01), prolonged hospitalization >7 days (3.5% vs. 6.7%, = 0.001), intensive care unit (ICU) admission (2.3% vs. 4.2%, = 0.01), and mortality (0.5% vs. 1.7%, = 0.01) when compared with those enrolled and unengaged with the technology. Patients with chronic conditions who were monitored with RPM upon hospital discharge were significantly less likely to experience 30-day readmissions (18.2% vs. 23.7%, = 0.03) compared with those unmonitored. Ninety-five percent of patients strongly agreed or agreed they were likely to recommend RPM to a friend or family member.
The Mayo Clinic RPM program has generated positive clinical outcomes and is satisfying for patients. As technology advances, there are greater opportunities to enhance this clinical care model and it should be extended and expanded to support patients across a broader spectrum of needs. This report can serve as a framework for health care organizations to implement and enhance their RPM programs in addition to identifying areas for further evolution and exploration in developing RPM programs of the future.
医疗保健领域中众多因素相互交织，使得人们越来越关注用于管理患者居家护理的新工具和方法。远程患者监测（RPM）是一种在家中提供护理并保持患者与医护人员联系以解决持续医疗问题的选择。
梅奥诊所开发了一项由护士主导的RPM计划，用于疾病和术后管理，通过让患者更直接地参与自身医疗保健来改善患者体验、临床结果并降低医疗保健利用率。登记的患者会收到一个技术包，其中包括一台数字平板电脑和用于收集症状及生命体征的外围设备。数据从这些设备传输到集成在电子健康记录中的中心。护理团队成员协调患者需求、对生命体征警报做出响应，并利用这些数据进行个性化患者评估、患者教育、药物管理、目标设定和临床护理规划。
自该计划启动以来，RPM计划已在17个项目中为近22,000名患者提供了支持。参与COVID-19 RPM计划的患者与使用该技术但未参与的患者相比，30天全因住院率显著更低（13.7%对18.0%，P = 0.01），住院时间延长超过7天的比例更低（3.5%对6.7%，P = 0.001），重症监护病房（ICU）入院率更低（2.3%对4.2%，P = 0.01），死亡率也更低（0.5%对1.7%，P = 0.01）。与未接受监测的患者相比，出院时接受RPM监测的慢性病患者30天再入院的可能性显著更低（18.2%对23.7%，P = 0.03）。95%的患者强烈同意或同意他们可能会向朋友或家人推荐RPM。
梅奥诊所的RPM计划产生了积极的临床结果，并且让患者感到满意。随着技术的进步，有更多机会改进这种临床护理模式，并且应该将其扩展以支持更广泛需求的患者。本报告可作为医疗保健组织实施和改进其RPM计划的框架，同时也有助于确定未来开发RPM计划时进一步发展和探索的领域。
