How to Choose the Right Monitoring Approach for Optimal Patient Care

Introduction

In the evolving landscape of healthcare, the debate between continuous health monitoring and intermittent health monitoring has become increasingly relevant, particularly within the context of Remote Patient Monitoring (RPM). Understanding when and why to prefer continuous monitoring over intermittent or standard monitoring is crucial for optimising patient outcomes and resource allocation.

Defining Continuous, Intermittent, and Passive Monitoring

Continuous Monitoring involves constant, real-time tracking of a patient's vital signs and health metrics using various digital health devices. In the context of Doccla’s services, continuous monitoring typically means tracking data over a longer period, such as 2-14 days. This approach provides immediate insights into a patient's health status, enabling timely interventions and preventing complications.

Intermittent Monitoring involves checking a patient’s health status at regular intervals or as needed, rather than continuously. Most of Doccla’s pathways, even acute ones, use intermittent monitoring. This method is often sufficient for many patients, providing reliable data while being less resource-intensive.

Passive Monitoring represents the future of health monitoring. This approach allows for data collection at any point without requiring the patient to actively engage or apply a device. Passive monitoring provides continuous insights into a patient’s condition seamlessly and effortlessly, enhancing patient comfort and compliance.

Why Prefer Continuous Monitoring?

Continuous monitoring has several benefits, but it’s essential to apply it judiciously based on the patient's condition.

Pros:

1. Early Detection and Intervention: Continuous monitoring allows for the early detection of potential health issues, enabling healthcare providers to intervene promptly. This is particularly beneficial for managing highly volatile conditions and preventing acute exacerbations.
2. Improved Patient Outcomes: With continuous oversight, healthcare providers can ensure better management of patient conditions, leading to reduced hospital admissions and improved overall health outcomes.
3. Enhanced Patient Engagement: Continuous monitoring fosters a proactive approach to health management, encouraging patients to be more involved in their care. This leads to higher compliance rates and greater satisfaction.
4. Data Accuracy and Trends: Continuous monitoring can capture trends and fluctuations in a patient’s condition more accurately, providing valuable insights for managing chronic conditions.

“Continuous monitoring revolutionises patient care by providing an extensive amount of data that allows for detailed, real-time insights into a patient’s health. This approach not only enhances the accuracy and timeliness of interventions but also significantly improves patient experience. With data being generated passively, patients can maintain their daily routines without a requirement to submit their own readings. By leveraging advanced monitoring technologies, we ensure that patient care is both comprehensive and unobtrusive, ultimately leading to better health outcomes and higher patient satisfaction.”

‍Greg Edwards - Chief Medical Officer at Doccla

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Addressing Potential Challenges:

1. Resource Intensive: Continuous monitoring requires significant resources, including advanced technology and constant data management. Doccla addresses this by providing comprehensive support, including technology integration and clinical monitoring services, to manage these resources effectively.
2. False Positives/Negatives: Continuous monitoring can sometimes result in false positives or negatives, leading to unnecessary alarms and interventions. Doccla’s advanced algorithms and clinical oversight help minimise these occurrences by filtering data and focusing on clinically relevant alerts.
3. Digital Exclusion: Some patients, particularly those who are digitally excluded, may find it challenging to engage with continuous monitoring technologies. Doccla’s user-friendly interfaces and patient support services ensure that all patients can benefit from continuous monitoring, regardless of their digital literacy.

Addressing the Misconception: Hospital vs. Home Monitoring

A common question arises: If a patient requires continuous monitoring, shouldn't they be in a hospital with round-the-clock care? This is a valid concern and highlights the need to carefully consider the appropriateness of home monitoring for each patient. Key questions to ask include:

1. Condition Volatility: How volatile is the patient's condition? Highly volatile conditions may require closer, more immediate oversight that is best provided in a physical ward.
2. Safety and Wellbeing: Is the patient's safety and wellbeing adequately supported through remote monitoring? Continuous monitoring at home should only be considered if it does not compromise patient safety.
3. Resource Availability: Are the necessary resources, including technology and clinical support, available to effectively manage continuous monitoring at home?
4. Clinical Leadership: Ultimately, the decision should rest with clinical leadership, who can assess the risks and benefits based on the patient's specific medical condition and history.

When is Continuous Monitoring Preferred?

Not all conditions require continuous monitoring. The decision should be guided by clinical pathways and individual patient needs. Continuous monitoring is particularly beneficial for:

1. Highly Volatile Conditions: Conditions such as severe heart failure or unstable COPD benefit from continuous monitoring due to their fluctuating nature. Continuous data helps in managing these conditions more effectively.
2. Post-Surgical Care: Patients recovering from major surgeries can benefit from continuous monitoring to detect early signs of complications and ensure a smooth recovery process.
3. High-Risk Patients: Patients with high-risk profiles, such as those with a history of frequent hospitalisations or those on complex medication regimens, require continuous oversight to prevent adverse events.

The Role of Intermittent Monitoring

While continuous monitoring offers significant benefits, intermittent monitoring is often a sufficient and practical approach in many RPM settings.

Pros:

1. Efficiency: Intermittent monitoring is less resource-intensive, making it a cost-effective option for stable chronic conditions and low-risk patients.
2. Simplicity: It requires less frequent interaction with technology, which can be easier for patients, especially those who are digitally excluded.
3. Reliability: Regular check-ups and monitoring at set intervals provide reliable data for managing patient health without the need for constant oversight.

Addressing Potential Challenges:

1. Potential Delays: Health changes that occur between monitoring intervals may go unnoticed, potentially delaying intervention. Doccla mitigates this by providing clear guidelines and frequent follow-ups to ensure timely interventions.
2. Less Data Detail: Intermittent monitoring may not capture all the fluctuations in a patient's condition, potentially missing critical trends. Doccla’s comprehensive reporting and advanced analytics help bridge this gap by providing detailed insights during each monitoring session.

The Promise of Passive Monitoring

Passive monitoring represents an innovative approach that combines the best of both continuous and intermittent monitoring. By collecting data without requiring active patient engagement, passive monitoring ensures:

1. Seamless Data Collection: Patients can go about their daily lives without the need to interact with monitoring devices, reducing the burden on them.
2. Enhanced Compliance: Passive monitoring eliminates the need for patients to remember to take measurements, leading to higher compliance rates.
3. Comprehensive Insights: Continuous data collection provides a detailed picture of a patient’s health, similar to continuous monitoring, but without the need for constant clinical oversight.

How Doccla Provides Comprehensive Monitoring Solutions

Doccla is committed to delivering both intermittent and continuous monitoring solutions to meet the diverse needs of patients and healthcare providers. Our flexible RPM and virtual ward solutions are designed to support any monitoring requirement, ensuring optimal care for all patient profiles.

Comprehensive Support for All Monitoring Needs:

1. Customisable Solutions: Doccla's platform can be tailored to provide continuous, intermittent, and passive monitoring, depending on the clinical needs of the patient. This flexibility ensures that patients receive the appropriate level of care, whether they require constant oversight or periodic check-ins.
2. Seamless Integration: Our solutions integrate seamlessly with existing healthcare systems, providing a robust middleware layer for interoperability with Electronic Health Records (EHRs) like SystmOne, Cerner, and EMIS. This ensures that patient data is accessible and up-to-date, facilitating comprehensive care management.
3. End-to-End Service: Doccla offers an end-to-end service that includes software, devices, clinical support, patient onboarding, compliance monitoring, and logistics. This holistic approach ensures that all aspects of patient monitoring are managed efficiently, allowing healthcare providers to focus on delivering quality care.
4. Enhanced Patient Engagement: Our platform includes educational resources, digital coaching, and communication tools to engage patients actively in their care. This enhances patient compliance and satisfaction, leading to better health outcomes.

Support for Continuous Monitoring Resources:

Doccla not only provides the technology for continuous monitoring but also offers robust clinical support to manage these resources effectively. We have in-house clinical staff who are specifically trained in remote patient monitoring, and our services are registered with the Care Quality Commission (CQC). This ensures that our continuous monitoring services are of the highest quality and can provide the necessary clinical oversight.

Conclusion

In the context of Remote Patient Monitoring, both continuous and intermittent health monitoring have their roles. The key is to understand the specific needs of each patient and condition, guided by clinical pathways and technological capabilities. Continuous monitoring offers significant advantages for managing highly volatile and high-risk conditions, improving patient outcomes, and optimising healthcare resources. However, intermittent monitoring remains a valuable approach for stable and low-risk patients.

Doccla’s comprehensive RPM and virtual ward solutions are designed to support any monitoring requirement, ensuring that all patients receive the optimal level of care. By leveraging our flexible and integrated platform, along with our in-house clinical support, healthcare providers can deliver high-quality, efficient, and patient-centric care across all settings.

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