Enhancing hospital at home: The role of remote patient monitoring

Remote patient monitoring (RPM) is proving transformative in extending the hospital at home (HaH) model, which allows patients to receive hospital-level care within their own homes. This approach aims to increase patient eligibility, improve safety, and reduce costs. Currently, HaH is underutilized, often restricted to low-acuity patients who only require infrequent vital sign checks. By integrating RPM, HaH can extend care to moderate-acuity patients, including those needing more frequent monitoring, such as continuous single-lead ECG for heart failure (HF) patients.
RPM technologies, including vital sign monitors, ECG devices, and fall detectors, can be employed to match standard hospital monitoring frequencies of every 4-8 hours, thereby expanding HaH eligibility. For example, Massachusetts General Hospital has effectively used continuous single-lead ECG to safely manage patients with acute decompensated HF at home.
The use of RPM in HaH enhances patient safety by reducing risks associated with traditional hospital care, such as delirium and hospital-acquired infections. Additionally, RPM supports fall detection and prevention, a critical safety measure for home-based care. The deployment of RPM can also facilitate operational efficiencies by reducing the need for in-person evaluations, making HaH economically viable even in rural settings.
Furthermore, integrating RPM with HaH could lower costs. A cost analysis of Mount Sinai’s HaH program suggested a potential 3.5% reduction in per-episode costs by substituting in-person evaluations with RPM-enabled telenurse evaluations. Extending RPM use beyond discharge may also help reduce readmission rates and overall healthcare costs.