Incorporating remote patient monitoring in virtual pulmonary rehabilitation programs

Abstract

Most pulmonary rehabilitation (PR) programs have had to adapt due to the COVID-19 pandemic and associated restrictions. Current alternative home-based programs have limitations and require modification. In this paper, we outline a novel method to monitor home-based PR programs, which has the potential to improve PR safety and efficacy. This new method is based on a remote patient monitoring (RPM) system with connected smart devices that enables the Respiratory Therapist (RT) to have real-time access to patient data including heart rate and peripheral oxygen saturation during exercise. The RPM system also monitors daily physical activity, sedentary time, sleep quality, rescue inhaler use, and maintenance inhaler adherence, among other variables, which has the added advantage of predicting patterns consistent with symptoms that may require medical intervention. To increase privacy, data are anonymized at all levels and only the RT has access to patient information. RPM systems have the potential to give practitioners a holistic view of the participants’ health status to better evaluate them during the entire PR program and to improve self-management. As this is not a formal research study, we cannot make definitive conclusions about the efficacy of the system, and further research is needed to examine safety and to compare our approach to other ways of conducting PR.

Using Remote Technology to Engage Patients with Interstitial Lung Diseases in a Home Exercise Program: A Pilot Study

“…At the same time, WiFi use enables data collection and sharing [50,59,[65][66][67]. From the health professional perspective, the high adherence of patients with remote data sharing during home EPs may ensure safer exercises at appropriate intensities, provide direct readings without relying on participant interpretation, reduce costs, and help monitor exercise progression, symptoms, and signs of exacerbation [59,68,69].…”

Using a centralized nursing team to implement multi-specialty pediatric remote patient monitoring programs

“…However, a majority of RPM programs served adult populations with very little involvement in pediatrics. One RPM program that focused on pulmonary rehabilitation for older adults supplied patients with equipment then asked them to complete 8-week educational and exercise series while providers reviewed real-time biometric data submitted during these activities, allowing providers to complete rehab sessions during the pandemic ( Jangalee et al, 2021 ). Another monitored heart rate, temperature, oxygen saturation, and severity of symptoms in adult patients diagnosed with COVID to decrease staff utilization for management of these patients ( Shah et al, 2021 ).…”