Remote Monitoring Finds New Importance in COVID-19 Era
By David Hayes M.D.
This year will long be remembered as the year the COVID-19 pandemic overwhelmed healthcare systems around the world. From postponing elective surgeries to reassigning entire hospital units to coronavirus response, hospitals have gone to unprecedented lengths to cope with the pandemic.
These measures have been used both to prevent hospital capacity from being overwhelmed and to reduce the exposure risks of in-person patient visits. Telemedicine plays a crucial role to achieving both of these goals and will have clear benefits both during and after the pandemic.
Healthcare providers worldwide have embraced remote monitoring as a tool for lowering the risk of exposure to COVID-19. For any issue that can adequately be managed remotely, patients and caregivers should take advantage of the tools available. The HRS COVID-19 taskforce also issued new guidance on treating patients while limiting potential exposure. The taskforce recommends limiting in-person patient visits to serious issues regarding device leads or generators, a clear need for reprogramming, or other issues the physician believes absolutely requires an in-person visit. Routine follow-ups, the taskforce says, can be done remotely. This helps alleviate pressures on hospital capacity, particularly at a time when waiting rooms themselves have to change seating arrangements to avoid crowding that may increase infection risk. It also allows patients to better adhere to social distancing practices, reducing exposure risks for both those patients and their physicians.
But is it safe to do more follow-ups remotely? In 2010, results from the TRUST trial found that BIOTRONIK Home Monitoring was capable of reducing in-office follow-ups by 45%. The data from 102 US centers supported the successful approval by the FDA for multiple product claims, which to this day, remain unmatched. Results from the recently published “At Home” study showed that the BIOTRONIK Home Monitoring system could safely replace face-to-face follow-ups for pacemaker patients. Study authors found no significant difference between a group of patients who only received remote follow-up and one where follow-ups were conducted conventionally. The study followed 1,108 pacemaker patients in Japan over two years, building upon 2019’s RM-ALONE trial. RM-ALONE, which followed 445 pacemaker and ICD patients over two years, also found no significant safety difference between patient groups who had regular follow-ups through remote-only or conventional means.
Given that patients with cardiovascular disease are more likely to have severe COVID-19 cases, technology that may help reduce their exposure risk by keeping them out of hospital deserves careful consideration.
Remote monitoring also has another clear use, both during the current pandemic and afterward. Even in non-crisis times, unnecessary in-office visits and hospitalizations put a higher strain on healthcare systems, both in terms of capacity and costs. Remote monitoring can help alleviate capacity pressures and reduce costs. Given that patients with cardiovascular disease are more likely to have severe COVID-19 cases, technology that may help reduce their exposure risk by keeping them out of hospital deserves careful consideration.
Last week I talked through some of the key benefits of remote monitoring during a pandemic and some features that are particularly useful for physicians. To access the free video content you can sign up here.