Advocating for the Nursing Role in Remote Patient Monitoring Program Design and Implementation
Introduction
Healthcare service providers shift from disease management in the traditional clinical setting to embrace community management and remote management of patients to reduce the costs and enhance care efficiencies (Malasinghe, Ramzan, & Dahal, 2019). Remote patient monitoring technology has facilitated the monitoring of patients beyond the confines of the conventional hospital to the inclusion of places like the patient’s home for use for monitoring. This interview transcript details the nursing role during the design and implementation of a remote patient monitoring program.
Transcript
- Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?
Remote patient monitoring (RPM) enables the following up of patients outside the conventional hospital setting. The rise of wearable technologies, including mobile applications and mobile trackers for tracking consumers’ health, has become widely available, giving rise to medical wearable devices with the capability to track and manage diseases like diabetes. The purpose of the remote patient monitoring program is to address the various problems faced by modern healthcare and specifically our practice, including high costs, inefficiencies, and ineffectiveness of healthcare, limited utilization, access, and low quality of services primarily to patients in rural areas.
The implementation will mainly involve Telecare, an automatic, continuous remote monitoring of any lifestyle changes and emergencies overtime to manage the risks associated with patients living independently. Additionally, the program will focus not only on curative medicine but also on promotive and preventive aspects (Fathi, Modin, & Scott, 2017). The costs of implementation will vary between patients depending on their needs and the number of devices they require. However, from reviewing other institutions that have implemented similar programs, the average cost for an RPM unit is about $3500 (U.S. Department of Health & Human Services, n.d.).
- Who is your target population?
The remote patient monitoring program targets patients with chronic illnesses and those in areas where it is difficult to access healthcare services. The increase in the number of Americans insured has made it difficult for many patients, especially those with chronic illnesses, to receive personalized treatment and attention from their care providers who have to attend to more significant patients. RPM would, therefore, expand to patients nationwide access to care.
- What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
The implementation of RPM falls directly within the scope of the evolving roles of the nurses. Nurses have the responsibility to utilize telehealth services in providing care to patients in remote settings. Therefore, the input of the nurses will be integral in the designing of the program. With a focus on the provision of long-term health, self-management, and wellness, nurses will incorporate their unique set of skills gained from training and experience to inform the designing of interactive modules that would maximize patient involvement in their care for effective transitioning into independence. The nurse would also be integral in collecting views of other care providers and empowering providers to enhance the adoption of innovative ways to incorporate family support, pain management, and multidisciplinary remote care interventions into the RPM program design. Finally, the nurses will engage in collecting survey data to inform the requisite setup of the provider-to-patient ratio within the remote patient monitoring program (Su et al., 2019).
- What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
As a nurse, I recognize my role to advance the patient’s needs, ensuring that all decisions and programs are designed. Considering the RPM program will involve a patient group that has historically been neglected and had limited success to quality healthcare. The implementation of remote patient monitoring and the concurrent pressures of managing increased numbers of patients would introduce the risk of unsafe practices like discharging patients earlier than necessary. Therefore, while contributing to the design, I will ensure that policies are implemented to avoid risking quality care provided to the target population. Secondly, the telehealth service will actively and automatically monitor emergencies among the patients. I will ensure that within the RPM framework, appropriate design features are instituted to enhance easy access to vital patient data from any facility if they require emergency care in any facility other than the parent institution.
- What is the role of the nurse in healthcare program implementation? How does this role vary between the design and implementation of healthcare programs? Can you provide examples?
The American Telemedicine Association elaborates on the integral role of nurses in the implementation and success of telehealth by stating that the services intertwine with the functions of nurses to enable long-distance care provision. Besides, nurses engage in telemedicine implementation by taking charge of the data collection, follow-up, education, and monitoring of patients to provide coordinated multidisciplinary care. Like conventional bedside nursing, the nurses will participate in innovative pain management and family support through the RPM program. In areas where there has been a perennial shortage of healthcare service providers, the nurses will provide the needed quality care by taking up more patients than the rations that can be monitored without the use of remote technologies (Bashir & Bastola, 2018).
Unlike the designing phase, the nurses will be the primary implementers of the program instead of just providing input and advocacy during designing.
- Who are the members of a healthcare team that you believe is most needed to implement a program? Can you explain why?
Nurses are the members of the healthcare team who will be most required to implement remote patient monitoring. The nurses are present in communities as frontline healthcare workers are consistent and positioned critically in supporting all the components of the isolated [patient monitoring continuum, consequently having the most significant impact in healthcare. The nurses will act as transformational leaders, policy advocates, researchers, educators, and clinicians to ensure successful implementation (Fathi, Modin, & Scott, 2017).
Conclusion
In brief, the implementation of remote patient monitoring (RPM) in my practice will target opening up healthcare opportunities to communities who have been traditionally medically underserved due to limited access. The program will enable remote follow up and interventions for patients with chronic conditions. Nurses will play a vital role in the program’s design, advocating for patients within the implementation framework and the actual implementation.
References
Bashir, A., & Bastola, D. R. (2018). Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study. JMIR medical informatics, 6(2), e35. https://doi.org/10.2196/medinform.9080
Fathi, J. T., Modin, H. E., & Scott, J. D. (2017). Nurses advancing telehealth services in the era of healthcare reform. OJIN: The Online Journal of Issues in Nursing, 22(2), 1320-1325.
Malasinghe, L. P., Ramzan, N., & Dahal, K. (2019). Remote patient monitoring: a comprehensive study. Journal of Ambient Intelligence and Humanized Computing, 10(1), 57-76.
Su, D., Michaud, T. L., Estabrooks, P., Schwab, R. J., Eiland, L. A., Hansen, G., … & Siahpush, M. (2019). Diabetes management through remote patient monitoring: the importance of patient activation and engagement with the technology. Telemedicine and e-Health, 25(10), 952-959.
U.S. Department of Health & Human Services (n.d.). Telehealth Cost Considerations. https://aspe.hhs.gov/report/long-term-and-post-acute-care-providers-engaged-health-information-exchange-final-report/telehealth-cost-considerations