I believe that telemedicine and home monitoring of patients post hospital discharge will be more broadly adopted as common healthcare services. The reason that they have lagged in popularity up to now is that the reimbursement picture is confusing and physicians and nurses have not been trained in their use. These two types of services provide a substitution of technology for bricks-and-mortar investments and substitute technology for labor. A recent article discussed the involvement of Medtronic in home monitoring devices (see: Medtronic alliance looks to expand use of home-monitoring devices). Below is an excerpt from it:
Medtronic is known more for its pacemakers than its health care services. But the Minnesota-run multinational corporation actually has one of the longest track records in the field of remote-patient monitoring, with 15 years of experience — including the years before 2013, when Medtronic bought its way into the field by acquiring Twin Cities-based patient-monitoring device maker Cardiocom for $200 million. Cardiocom was focused on heart conditions, but Medtronic has worked to greatly expand the applicability of its home-monitoring devices. Medtronic has developed automated protocols to handle more than 20 different conditions and disease states, with a focus on complex patients who often have multiple conditions to manage. In addition to heart problems, the system manages diabetes, hypertension and psychological disorders.
American Well (see: Cerner Embeds Telehealth Capabilities into its EHR) is a provider of telemedicine services [and is now partnering with Medtronic Care Management Services]....From the patient’s perspective, Medtronic Care Management Services is a health-and-education service offered through phone or video, often using a small tabletop device with a screen or a tablet computer to ask automated health questions based on a person’s diseases....A patient with heart failure might be prompted with questions about sudden weight gain or difficulty breathing, which can signal onset of an acute episode. A patient with a new knee implant might be asked whether pain has increased or if they are having trouble urinating....With American Well, some patients will also get the chance to have live video visits with doctors on the same device.... From the hospital or insurance company perspective, Medtronic Care Management Services is a way to prevent costly hospital admissions by giving patients more education and a hands-on way to proactively monitor and manage their own health at home.
Telemedicine visits were initially focused on patients with minor illnesses (see, for example: Your Doctor in a Kiosk; A New Variant of Telemedicine). Telemedicne is now expanding its scope to include more complex interactions such as pre-surgical consultations by physicians (see: Surgeons Extol the Advantage of Telemedicine in Rural British Columbia). The fact that a manufacturer of home monitoring device, Medtronic Care Management Services, is partnering with a telemedicine vendor, American Well, makes perfect sense. Many hospitals are plagued with the problem of patients being discharged from the hospital too early for which they are financially penalized by Medicare. There have been various products introduced previously in the market for remote monitoring of patients at home after hospital discharge. (see: Hospitals Deploying Wireless Systems for Monitoring Patients; Identifying Patients for Remote Monitoring with Predictive Analytics; Aiming for Fewer Hospital U-turns: The Medicare Hospital Readmission Reduction Program).
Although basic wireless remote patient monitoring systems may be sufficient to monitor discharged patients whose condition may be deteriorating, it makes more sense to monitor them with some sort of desktop device with which the patient interacts and responds to questions as is the case with the Medtronic system. Such a device, of course, would optimally be paired with telemetric devices for measuring the patents vital signs and EKG. Of course, linking this to a telemedicine "visit" by a physician if there is evidence that the patient's status is deteriorating is an even better way to monitor such patients.