Economic Evaluations of Remote Patient Monitoring for Chronic Disease: A Systematic Review

Guzman, Keshia R. De; Snoswell, Centaine L.; Taylor, Monica; Gray, Leonard C.; Caffery, Liam J

doi:10.1016/j.jval.2021.12.001

Cited by 22 publications

(17 citation statements)

References 55 publications

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“…The present study is the first systematic review of the economic impact of RPM for CVD management, focusing on the US healthcare system. A previous systematic review involved thirty-four studies conducted in twelve countries for multiple chronic diseases (36). Their results revealed that RPM is a highly cost-effective intervention for hypertension and prevents high-cost health events in the long run from a wide variety of perspectives, which is consistent with our findings of studies from payer and healthcare perspectives (36).…”

Section: Discussionmentioning

confidence: 99%

“…A previous systematic review involved thirty-four studies conducted in twelve countries for multiple chronic diseases (36). Their results revealed that RPM is a highly cost-effective intervention for hypertension and prevents high-cost health events in the long run from a wide variety of perspectives, which is consistent with our findings of studies from payer and healthcare perspectives (36). However, our review includes a different set of studies, including partial and full economic evaluations, invasive and non-invasive RPM, and focused on CVD management in the US context.…”

Section: Discussionmentioning

confidence: 99%

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Economic evaluation and costs of remote patient monitoring for cardiovascular disease in the United States: a systematic review

Zhang

Peña

Fletcher

et al. 2023

Int J Technol Assess Health Care

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Background Remote patient monitoring (RPM) has emerged as a viable and valuable care delivery method to improve chronic disease management. In light of the high prevalence and substantial economic burden of cardiovascular disease (CVD), this systematic review examines the cost and cost-effectiveness of using RPM to manage CVD in the United States. Methods We systematically searched databases to identify potentially relevant research. Findings were synthesized for cost and cost-effectiveness by economic study type with consideration of study perspective, intervention, clinical outcome, and time horizon. The methodological quality was assessed using the Joanna Briggs Institute Checklist for Economic Evaluations. Results Thirteen articles with fourteen studies published between 2011 and 2021 were included in the final review. Studies from the provider perspective with a narrow scope of cost components identified higher costs and similar effectiveness for the RPM group relative to the usual care group. However, studies from payer and healthcare sector perspectives indicate better clinical effectiveness of RPM relative to usual care, with two cost-utility analysis studies suggesting that RPM relative to usual care is a cost-effective tool for CVD management even at the conservative $50,000 per Quality-Adjusted Life-Year threshold. Additionally, all model-based studies revealed that RPM is cost-effective in the long run. Conclusions Full economic evaluations identified RPM as a potentially cost-effective tool, particularly for long-term CVD management. In addition to the current literature, rigorous economic analysis with a broader perspective is needed in evaluating the value and economic sustainability of RPM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Economic evaluation and costs of remote patient monitoring for cardiovascular disease in the United States: a systematic review

Zhang

Peña

Fletcher

et al. 2023

Int J Technol Assess Health Care

View full text Add to dashboard Cite

show abstract

“…An economic review of RPM for chronic diseases demonstrated the variability of cost-effectiveness depending on clinical context, investment, and organizational processes, and found RPM for hypertension is highly cost effective. 58…”

Section: Key Challengesmentioning

confidence: 99%

Innovative Remote Management Solutions for the Control of Hypertension

Lee

Fisher

2023

Hypertension

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We stand at a critical juncture in the delivery of health care for hypertension. Blood pressure control rates have stagnated, and traditional health care is failing. Fortunately, hypertension is exceptionally well-suited to remote management, and innovative digital solutions are proliferating. Early strategies arose with the spread of digital medicine, long before the COVID-19 pandemic forced lasting changes to the way medicine is practiced. Highlighting one contemporary example, this review explores salient features of remote management hypertensive programs, including: an automated algorithm to guide clinical decisions, home (as opposed to office) blood pressure measurements, an interdisciplinary care team, and robust information technology and analytics. Dozens of emerging hypertension management solutions are contributing to a highly fragmented and competitive landscape. Beyond viability, profit and scalability are critical. We explore the challenges impeding large-scale acceptance of these programs and conclude with a hopeful look to the future when remote hypertension care will have dramatic impact on global cardiovascular health.

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“…By expanding patient eligibility for HaH, RPM could decrease per-episode fixed cost allocation by enabling programs to run closer to capacity. To our knowledge, no literature exists evaluating the cost-effectiveness of RPM programs for HaH; however, studies evaluating RPM for chronic conditions, such as HF, COPD, and hypertension, have shown signs of cost-effectiveness [ 22 ]. Key drivers of cost-effectiveness identified for RPM for chronic illnesses include capital investment, clinical setting, and organizational processes involved in RPM implementation and delivery; therefore, programs should monitor expenditure closely and share best practices to mitigate unnecessary cost variation [ 22 ].…”

Section: Opportunities For Remote Patient Monitoring For Hahmentioning

confidence: 99%

The Next Frontier of Remote Patient Monitoring: Hospital at Home

Whitehead¹,

Conley²

2023

J Med Internet Res

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Remote patient monitoring (RPM) has shown promise in aiding safe and efficient remote care for chronic conditions; however, its use remains more limited within the hospital at home (HaH) model of care despite a significant opportunity to increase patient eligibility, improve safety, and decrease costs. HaH could achieve these goals by further adopting the 3 primary modalities of RPM (ie, vital sign, continuous single-lead electrocardiogram, and fall monitoring). With only 2 in-person vital sign checks required per day, HaH patient eligibility is currently often limited to lower-acuity cases. The use of vital sign RPM within HaH could better match the standard clinical practice of vital sign checks every 4-8 hours and enable safe care for appropriate moderate-acuity medical and surgical floor-level patients not traditionally enrolled in HaH. Robust, efficient collection of more frequent vital signs via RPM could expand patient eligibility for HaH and create a digital health safety net that enables high quality care. Similarly, our experience at Massachusetts General Hospital has demonstrated that appropriate use of continuous single-lead electrocardiogram RPM can also expand HaH enrollment, particularly for patients with acute decompensated heart failure. Through increasing enrollment of patients in HaH, RPM stands to enable more patients to reap the potential safety benefits of home hospitalization, including decreased rates of delirium and hospital-acquired infections, and better avoid aspects of posthospital syndrome. Furthermore, instituting fall detection RPM allows care teams to further HaH patient safety during their episode of acute care and develop enhanced mitigation strategies to avoid falls post home hospitalization. RPM also has the potential to assist HaH in achieving greater economies of scale and decreasing direct variable costs. By expanding HaH eligibility, RPM could enable HaH programs, which have traditionally operated under capacity, to care for a larger census and decrease allocated fixed costs per hospitalization. Additionally, RPM for HaH could further optimize hybrid in-home and remote nurse or physician evaluations, decreasing costs on a per-episode basis by up to an estimated 3.5%. Overall, RPM holds great promise to increase patient eligibility and patient safety while decreasing costs. However, it is in its infancy in achieving its potential to advance the HaH model of care; further research and experience that inform operational and technical as well as policy considerations are needed.

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Economic Evaluations of Remote Patient Monitoring for Chronic Disease: A Systematic Review

Cited by 22 publications

References 55 publications

Economic evaluation and costs of remote patient monitoring for cardiovascular disease in the United States: a systematic review

Economic evaluation and costs of remote patient monitoring for cardiovascular disease in the United States: a systematic review

Innovative Remote Management Solutions for the Control of Hypertension

The Next Frontier of Remote Patient Monitoring: Hospital at Home

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