How wearable tech can enable seamless RPM during COVID-19

Patients have generally gone to their doctor's offices to obtain remote monitoring devices – but the pandemic is proving they don't have to.
By Kat Jercich
09:22 AM

At least 2.7 million people in the United States have atrial fibrillation, or an irregular heartbeat sometimes known as AFib. According to the American Heart Association, the risk for strokes among people with untreated AFib is five times as high as for those without. They are also twice as likely to die of a heart-related condition.

Even so, says Judy Lenane, chief clinical officer for iRhythm Technologies, many AFib patients don't even know they have it.

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"If we could identify who's at risk – who would benefit from being identified before they have their first stroke – that's what we get excited about," said Lenane.

iRhythm, a San Francisco-based med tech company, combined remote-monitoring and analytics technologies with its Zio wearable patches. As a viable way to detect AFib among patients with increased risk but no known heart rhythm issues, the Zio patches offer an alternative to traditional – often unwieldy – cardiac-monitoring hardware.

With the COVID-19 pandemic still preventing many patients from seeking in-person services, Lenane argued, Zio is an example of the ways remote patient monitoring can be used to minimize interruptions in care.

"With this rapid change," she said, "we saw the need for monitoring still continue," said Lenane. Before the coronavirus crisis, she said, about 5% to 10% of patients were applying the devices themselves – the remainder would have their devices applied in their doctor's office.  

"When COVID hit in early March, we saw those numbers transform overnight," she explained. In a 2019 study, iRhythm found no difference in median analyzable time between the patients who applied their devices at home and those who had their devices applied in the office. In April, iRhythm began offering at-home enrollment for the devices. 

"I really do believe it's in its infancy," said Lenane about potential developments in the remote patient monitoring field. A question shaping continued research, she said, is "how do you monitor vital signs and other biomarkers ... to really understand a patient who might be at risk?"

Lenane also pointed to the possibility for wearable devices to improve care among underserved populations. The company has worked with safety-net hospitals to connect patients with lower incomes or who live in rural areas with the technology. 

In studies, she said, "we saw [patients] could absolutely comply" with instructions to return the device for analysis, "and did a fabulous job." 

An open question remains among providers and telehealth advocates about which virtual care-related regulations – particularly those relaxed by the U.S. Department of Health and Human Services – may remain permanent, allowing for continued coverage. As others have done, Lenane noted that part of telehealth's longevity will be determined by economic factors. 

"I'm very curious to see what'll happen, long-term, with telehealth," said Lenane. "We believe that it will stay, but I believe the financial perspective will make a difference."

"There will be some things you have to go face-to-face," she acknowledged. "But for surveillance, maintenance and safety devices, telehealth will be an option for patients to choose from."

Ultimately, Lenane said, remote patient-monitoring for chronic conditions will require patient buy-in. 

"To me, success is all going to be built around: Can patients use it easily, do patients want to use it, and do providers help them understand the value of long-term tools?" she said.

Actionable Intelligence

This month, we look at lessons from the COVID-19 pandemic on how data is put to work informing patient care decisions and population health.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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