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Dimensions of Remote Patient Monitoring (RPM) to Consider when Buying

The Remote Patient Monitoring (RPM) sector is set to grow over the next 5 years. With so much projected demand in this space, buyers are in a frenzy to compare product features to see what would best fit their needs. Standardization was a highly attractive proposition to hospital administrators according to a Google report released back 2013. It would make more sense to go with a product that has multiple core functionalities. But in recent times, new care avenues have emerged, and one might need specialized RPM solutions to truly add value to patients or to care providers. The debate between standardization and specialization is a something buyers will need to make, and it will have ripple effect on the rest of the healthcare product ecosystem as the RPM modality matures. Currently however, the RPM market has not yet reached that level of maturation. There exist multiple vendors who are all interested in marketing RPM with a varied assortment of benefits, features and solving multiple needs for many different clients. A clear industry leader has not emerged yet, as the space continues to be defined by extant companies and newcomers.

I thought it would be an interesting exercise to see how all the current products in the RPM space line up currently. It would be good to find out how many of their features overlap with each other and how many of them are unique. By doing such an analysis of all current vendors, it gives one a clearer picture of the possibilities that exists when it comes to remotely monitoring patients. What was interesting is that at the surface level, the core functionalities offered by all vendors looks pretty much the same. If a buyer does not have an idea on what basis to compare all these solutions, then it is possible to get lost in the myriad of website copies, all of which somewhat offer the same type of things, albeit written differently.

The Process

In Google, I searched for the keyword “Remote Patient Monitoring Vendors”. Whenever I came across a search result of a vendor’s website, I noted that vendor down, along with all features and benefits it was offering. Such characteristics of the product were organized in columns, and new vendors appearing in the search results were added in the rows, with their corresponding benefits and features marked in the columns. Such an exercise seemed futile at first, because so many companies promised the same basic set of functionalities and stretched the proposition of these functionalities to tailor their offering to a market to a group as diverse as possible. But eventually, it became noticeable that some vendors did have an unique selling proposition, but more commonly, the language used to describe the products was disposed more towards a certain type of orientation. It was such differences in disposition that enabled me to come up with the following dimension scales. By observing the marketing language of the products and benefits, a vendor can be placed an any point of each of these scales.  It is important for a first-time buyer to consider all of these scales, as it’s these dimensions that offer true differentiation in the RPM space.

4 different dimensional scales were identified. They are listed below.

Hardware vs Software

It’s crucial that a buyer is clear on what component of a solution is more important to them. Some companies pride themselves on producing the latest monitoring equipment, both for inpatient and outpatient settings. Such devices cause minimal discomfort, if any at all, to the patient, while capturing all their biosignals, and transmitting them on to state-of-the-art monitoring devices where they can be tracked by a healthcare professional. The capturing, processing and displaying of biosignals is the main point of differentiation here, as such companies continually update their product series with the latest version which is an improvement over the last.

On the other side of the spectrum, there are those who focus more on software. It is understandable as they are not product manufacturers, and so their software is the main attraction.  The software pride themselves on being the most user friendly, and boast all features that we expect from RPM, such as, alerts, reminders, patient engagement buttons, video visits, analytics, etc. For those that promote software on their site, it is more about the robustness and usability of the interface, and less about the latest specification of the equipment, which is more a trait for those in the hardware camp.

Specialty vs General

Some companies really go out of their way to specialize at a certain disease or body organ.  For diseases it can be diabetes, Chronic Obstructive Pulmonary Disorder (COPD), Congestive Heart Failure (CHF), or hypertension, where companies will advertise certain regimen uniquely suited to deal with the diseases. Going in the other direction of the scale, there are some companies who will group all such conditions under chronic care, (which they are), as patients are usually afflicted with them at some level for the rest of their lives.  Going forward even further in the scale, and crossing over to the general spectrum, there are companies who do not have different pages addressing each of these diseases, and  don’t want to pigeonhole themselves in the chronic care box either. They cater to all situations which may require patient monitoring, including acute and critical care.

There is another type of specialty involved amongst RPM companies which involves body organs, but mainly, the heart.  There is an extra layer of expertise involve when it comes to monitoring ECG data, and vendors compete on ways how this can be best achieved with some coming up with ways that is even marked for approval by governmental agencies. Besides the heart, the other major specialization of body organ would be the lungs, where some companies have specific pages devoted to respiratory care, detailing how they would monitor all thoracic activity.  Again, it’s not standard for all vendors to emphasize their cardiac or respiratory monitoring. They could simply take the more general approach and focus concurrently on multiple care areas in a hospital, such as the ICU, neonatal unit or operation theater.

Patient Centric vs Hospital Centric

When it comes to target groups for RPM solutions, the two biggest stakeholders are hospitals and their patients. Physicians come a close third, as they have to be trained on the products and ultimately would be in a position to best judge the utility of the solution. Indeed, intuitive usability and provision of training for doctors are features claimed by many vendors. Payers and pharmaceutical companies are also important target groups who have an interest in RPM to use it for billing management and for pharma trials respectively. But as far as stakeholders go, the two biggest benefactors are patients and hospitals, with RPM companies making their case to both parties.

Depending on who is more appealed to, the position of the RPM solution in the patient hospital -continuum is fixed. To appeal to patients, features encouraging and facilitating engagement are promoted, as are the customization of care plans, and two-way video calls with physicians. While video visits are traditionally a separate medium of telehealth separate from RPM, most patient focused RMP solutions include it as a must have feature for ease of communications regarding the patients’ biodata. On the hospital side of things, everything is centered around operations and optimal decision making. Thus, there is heavy promotion of activity logs and clinical workflows by which clinicians can interpret and execute a given care plan by looking at the timeline of a patient. There is the care provider dashboard which acts as hub of information from patients, thus enabling operations to get a holistic view of a patient population. Some vendors also tie clinical operations to financial operations by tracking revenues through billable codes. Thus, these are all features which are written with the hospital in mind. The patient is seen as just as one part of the whole system, but not the centerpiece as it’s the case with patient-centric RPMs.

Predictive Analytics vs Decision Support

This scale is not as elaborate as other three above, but it is nevertheless a distinction that should be made. There is a lot of investment going into developing Artificial Intelligence (AI) technologies. Via means of predictive analytics, physicians can be put in a position to best choose the correct course of outcome for a patient. Vendors appropriately market such features as machine learning where one can study their patient population.

The other end of the scale is more present oriented, which only provides the type of intelligence needed to support intermediate and immediate decision making. By monitoring all vital signs, and analyzing all data points from the patients, the care plan is continually optimized so the patient can be discharged quickly and remain healthy after discharge via post discharge monitoring. Both predictive analytics and decision support are examples of evidenced based practices. The former is more long term oriented and seeks to understand the patient population, while the latter is more short-term oriented and deals with a solitary patient on a case by case basis.

Final Word

It is important to remember that the four dimensions above are in a scale format, it is not a case of being one over the other. Indeed, very few vendors exclusively focus on just one trait while ignoring the other end of the scale. Most tend to hog the center of the scale. But as there are 4 dimensions provided, there is  plenty of scope for differentiating oneself from the rest by choosing one’s mix of features and benefits. More importantly from the buyer’s point of view, only by understanding the extremes of what is possible in the market, can a decision be made on the right solution. By considering all 4 scales, and answering the following 4 questions based on them, a buyer can narrow down the list of prospects.

  1. Am I looking to buy just software which is device agnostic, or do I need tangible infrastructure for the hospital as well?
  2. For whom am I buying RPM? Is it for a department, or a certain type of patient population? Or is it just something to develop the home care unit of the hospital?
  3. While everyone stands to benefit from RPM, who do I want to empower more by using such technology, physicians or the patients?
  4. Do I need to tool that is more suited towards studying my patient population, or treating my patient population?

I hope this article gave you some clarity on where to start when looking for a RPM solution. What do you think of the 4 dimensions?  Email me at rahat.haque@aetonixsystems.com. Or let us know on our media channels.

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We are Aetonix. We simplify complex healthcare. Full disclosure, we are in Telehealth. But we are involved in Remote Patient Monitoring for those who needed it most, patients suffering from complex needs.

References

https://www.globenewswire.com/news-release/2019/07/22/1885640/0/en/

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