Page 10 Telehealth and Remote Patient Monitoring RPM for Long Termand Post Acute Care A Primer and Provider Selection Guide 2013

5

2.4.1.2 Remote Patient Monitoring another via electronic communications to improve
a patient’s clinical health status.” Two-way video,
Remote patient monitoring (RPM) is a type of email, smartphones, and wireless tools are examples
home telehealth that enables patient monitoring of a growing variety of telemedicine applications
as well as transfer of patient health data to a health and services. While the terms “telehealth” and
12
care provider. To capture data, these technolo- “telemedicine” are often used interchangeably,
gies use a variety of wired or wireless peripheral telemedicine can be more narrowly defined to
measurement devices such as blood pressure cuffs, mean the delivery of remote clinical services using
scales, and pulse oximetry, and they are most often technology. Examples of telemedicine include a
used after a hospital discharge or between routine physician’s review of a patient’s digital images (i.e.
office visits. Some technologies also permit video x-rays, CT scans, MRI) via a computer, a physician
interaction/chat between the patient and health consult done via a web conference, or telephar-
care professional in real-time. These systems can macy whereby pharmacy technicians can prepare
prompt users to enter answers to targeted questions, prescriptions under the supervision of a qualified
and then use this information for data interpreta- pharmacist remotely.
tion, provision of educational materials, as well as
instructions such as scheduling an office visit or 2.4.2 Telecare/Telemonitoring/Behavioral
going to the nearest emergency room. Similarly, Monitoring capabilities
these systems can transmit user-entered data, store
the data in secure records systems accessible to Telecare/telemonitoring/behavioral monitoring
clinicians, flag abnormal readings or responses, capabilities technologies include sensors to monitor
and alert clinicians to abnormalities via e-mail or functional abilities, activities of daily living, behav-
text messages. In response to these alerts, clinicians iors, sleep patterns etc.
can log into the system, review data, follow up with
patients, or take other appropriate actions. Some 2.5 Clinical Decision Support Systems
systems have the capacity to connect patients with
additional resources such as PHR or EMR, targeted Clinical decision support (CDS) systems provide
educational materials, interactive self-care tools, clinicians, staff, patients or other individuals with
medication optimization technologies, and health knowledge and person-specific information, intel-
care providers. Although applications of RPM ligently filtered or presented at appropriate times, to
10
technologies are often used in the home setting, enhance health and health care. CDS encompasses
these technologies have been pilot-tested in con- a variety of tools to enhance decision-making in
gregate settings such as community-based senior the clinical workflow. These tools include com-
centers. 11 puterized alerts and reminders to care providers
and patients; clinical guidelines; condition-specific
2.4.1.3 Telemedicine order sets; focused patient data reports and summa-

Formally defined, telemedicine is the “use of ries; documentation templates; diagnostic support,
medical information exchanged from one site to and contextually relevant reference information,
among other tools. CDS systems offer sophisti-
13

Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013