Remote Patient Monitoring: A Human Factors Assessment

The Study Context Telehealth remote patient monitoring applications are being used increasingly in chronic disease management because patients are leaving the hospital after acute episodes still needing care. Monitoring applications may have several purposes, but two are typical: to provide continuing care to patients and to educate patients, enabling them to better manage their condition and avoid hospital readmission and costly visits to emergency rooms. Some of these applications are quite sophisticated from a clinical perspective; some are much simpler. Western Michigan University, in collaboration with a local visiting nurse agency, conducted a longitudinal randomized control trial of the Health Buddy (Bosch Healthcare)i remote telemonitoring and patient education system, via funding support from the Health Resources and Services Administration (Grant 1 D1B TH 0374401) from 2006 to 2008. Subjects were patients with heart failure (HF) or chronic obstructive pulmonary disease (COPD) who had just been discharged to homecare after hospitalization for an acute episode. Those patients who were eligible for the study, based on both diagnostic criteria and criteria for telehealth, were randomly assigned to receive standard homecare alone or standard homecare with a 60-day telehealth program specific to their illness (either an HF or COPD program). In all, a total of 19 patients participated in the telemonitoring group, and 27 in the control group. Subjects were followed for one year post-discharge and many clinical and non-clinical outcomes were assessed at various points in this one-year period. (See Table 1 for a list of outcome measures and assessment tools used in the study.) Not unlike many Remote Patient Monitoring: A Human Factors Assessment