Reviewed by: Kamal Jethwani, MD, MPH
Chronic respiratory conditions, such as Chronic Obstructive Pulmonary Disease (COPD), are a major public health issue affecting millions of people across the globe. According to the Centers for Disease Control & Prevention (CDC), COPD is the 3rd leading cause of death in the U.S., with a high economic burden attributed to the treatment of exacerbations. Clinical researchers predict a potential increase in the number of people living with chronic respiratory conditions, such as pulmonary fibrosis (lung scarring), due to long-term lung damage that could occur in people who have been infected with Covid-19.
As a result of the pandemic, innovative digital health solutions have rapidly emerged and evolved, especially remote monitoring programs, to help physicians, respiratory therapists and clinical care teams manage high-risk respiratory patients within healthcare’s “new normal.”
In this post, we’re going to look at 5 of the most compelling reasons why digital health makes sense for people living with chronic lung conditions such as COPD, severe asthma, and lung damage related to Covid-19. Before we dive into our Top 5 list, let’s first review some common terms that are most often used when talking about digital health.
Digital Health: What Is Remote Patient Monitoring?
In the Digital Health Playbook, the American Medical Association (AMA) defines remote patient monitoring (RPM) as “a digital health solution that captures and records patient physiologic data outside of a traditional health care environment.” RPM facilitates patient monitoring through real-time (or near-time) transfer of patient-generated data from the patient to care teams through Bluetooth or cellular-connected medical devices, called peripherals.
Patients generally use peripheral devices in the home. The data captured from the device is transmitted to a secure, cloud-based mobile application and/or a provider portal where the clinical team can review the results on a patient dashboard or electronic medical record.
Mobile health (mHealth) has recently become very popular as a self-management tool for specific conditions and is generally in the form of a healthcare software application downloaded to a mobile device (such as a mobile phone or tablet). A healthcare app may be used by itself or also as part of a remote monitoring program.
Now, let’s discuss some reasons why and how digital health solutions can improve care for chronic lung patients (in no particular order)!
- Most people with chronic health conditions would choose RPM
Remote patient monitoring has been around for a while but quickly gained momentum out of necessity due to the COVID-19 pandemic and social distancing. While remote monitoring shouldn’t be considered a substitute for in-office exams, a digital health survey shows almost 60% of healthcare consumers say they would choose remote monitoring for chronic health issues using at-home devices (if given the option).
Interest in remote monitoring existed well before Covid-19, as evidenced when a pre-pandemic RPM survey identified the following patient benefits (of RPM):
- influence on “their own well-being” through ownership of health data (37%)
- improved compliance rates (44%)
- access to detailed personal health information (43%)
The bottom line is that people want to be more engaged in their own healthcare. This speaks directly to the popularity of mHealth remote monitoring solutions such as healthcare apps, wearables to monitor vital signs, connected treatment devices, and other self-management tools.
- RPM may improve medication adherence AND alert care teams to non-compliance issues for intervention
Medication adherence in COPD patients is essential to improve disease symptoms and prevent exacerbations; however, adherence is generally low. A couple of reasons for non-compliance that respiratory therapists often see include patients having difficulty maintaining proper inhaler technique as their chronic lung disease progresses, forgetting to take their medication and higher costs for some inhaler medications. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends prescribing respiratory medications for COPD patients based on their individual preference, economic factors, and physical abilities.
A portable nebulizer can help address common issues severe COPD patients may face that can make it challenging to adhere to medication schedules, such as reduced muscle strength and poor hand-breath coordination. Nebulizers don’t require a special user technique for effective medication delivery. In addition, medication reminders can be set-up and treatment usage data can easily be tracked when a patient is using their connected nebulizer.
For example, when AireHealth’s connected nebulizer is paired with the MyAireHealth companion app, nebulizer usage is transmitted to the provider portal, alerting the care team to any over or under nebulizer usage which may signal a need for proactive intervention. Patients and caregivers can also add other relevant information regarding symptoms and activity level to give providers and the respiratory care team more insight into how they are doing on a daily basis.
- Encourages patient connection and collaboration with the care team between in-office visits
Some patients do not have reliable transportation to and from their in-office appointments. This could be due to many factors, such as lack of access to public transportation, living in a rural setting far away from their family and healthcare provider, or simply not being able to drive due to the severity of their lung condition. Remote monitoring enables patients to maintain a connection with their physician and care team while offering peace-of-mind. Many RPM platforms include two-way video or phone conferencing and text messaging capabilities to encourage ongoing engagement and collaboration between the patient and provider between office visits.
Self-management diary apps (mHealth) using a mobile or smartphone can provide care teams with meaningful and actionable data to augment their clinical assessment. Additionally, another important feature of some self-management apps, including MyAireHealth, is the ability to share data with clinical teams and/or family members living in another state, if desired.
The latest 2021 GOLD guidelines include a section for “Remote COPD Patient Follow-Up During Covid-19” and a comprehensive “COPD Remote Follow-Up Checklist” to help respiratory therapists, physicians, nurses, pharmacists and other clinical staff to guide virtual discussions with COPD patients about their medication adherence, and other types of information to identify potential issues.
- Provides care team with daily insights to support proactive clinical intervention and reduce healthcare utilization due to COPD exacerbations
Physicians now have more options available when selecting peripheral devices as part of a respiratory-focused RPM program. Examples of RPM connected devices (aka peripherals) for monitoring patients with chronic lung disease include pulse oximetry for SpO2, a Bluetooth-enabled nebulizer to track daily medication adherence, sensors to track inhaler usage (MDI/DPI), and a portable spirometer to assess lung function.
A recent COPD remote monitoring study suggests that RPM programs with “a broader range of real-time symptoms and parameters” could provide care teams with a more realistic view of daily life for someone living with COPD. RPM programs that capture these types of data may be used to guide appropriate interventions aimed at reducing healthcare utilization in COPD patients.
- Remote patient monitoring codes exist for billing RPM services
The Centers for Medicare and Medicaid Services (CMS) reimbursement policies and other regulations have helped fuel the rapid adoption of remote patient monitoring. CMS recently released the latest RPM updates to the 2021 physician fee schedule, which provides the average reimbursement amounts for the CPT codes and guidance for providers to bill for remote patient monitoring. The CPT codes commonly used for billing RPM generally include services provided for a one-time patient set-up, monthly data transmission, and monitoring services by clinical staff. Most RPM vendors will provide monthly reports that physician office staff can use to facilitate billing submissions.
The Future of Digital Health Solutions for COPD Patients
In 2020, many healthcare leaders predicted that “the genie is out of the bottle!” when referencing the rapid adoption of digital health and remote patient monitoring. All signs indicate digital health is here to stay and that remote patient monitoring will continue to grow and evolve. In this post, we provided five reasons why digital health makes sense for chronic lung patients; however, there are many more we could have selected, and the list of remote monitoring benefits continues to grow as more innovative solutions emerge.
Stay tuned for our next clinical blog as we dig deeper into medication adherence and explore the critical role respiratory therapists play in digital health programs.
For information regarding AireHealth’s digital health solution for chronic respiratory management or to discuss potential partnering opportunities, please contact email@example.com to schedule an informational meeting or product demonstration or visit AireHealth’s website at www.aire.health.