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Remote Patient Monitoring: Delegation of Responsibility

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Healthcare Information Technology for Cardiovascular Medicine

Part of the book series: Health Informatics ((HI))

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Abstract

Wearable remote monitoring devices are increasingly being deployed to patients and utilized to extend patient data collection outside of conventional clinical encounters. The use of ambulatory monitoring devices in cardiology enables long-term, remote data collection for reliable diagnostics and continuous monitoring of cardiac disease. Despite the many advancements, there is still much work that needs to be done in terms of research to improve our understanding of actual outcomes and benefits of these tools. It is also critical to determine which patient populations are best suited to benefit from the use of these devices. This chapter provides a review of RPM devices in cardiology, and an overview of some key considerations in their use clinically with respect to safe, effective and efficient use of the data to impact patient care and outcomes.

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References

  1. DeVore AD, Wosik J, Hernandez AF. The future of wearables in heart failure patients. JACC Heart Fail. 2019;7(11):922–32.

    Article  Google Scholar 

  2. Liao Y, Thompson P, Peterson S, Mandrola J, Shaalan M. The future of wearable technologies and remote monitoring in health care. Am Soc Clin Oncol Educ Book. 2019:115–21.

    Google Scholar 

  3. Malasinghe L, Ramzan N, Dahal K. Remote patient monitoring: a comprehensive review. J Ambient Intell Humaniz Comput. 2019;10:57–76.

    Article  Google Scholar 

  4. Queiros A, Alvarelhao J, Cerqueira M, Silva AG, Santos M, Rocha NP. Remote care technology: a systematic review of reviews and meta-analyses. Technologies. 2018;6:22.

    Article  Google Scholar 

  5. Berridge C. Medicaid becomes the first third-party payer to cover passive remote monitoring for home care: policy analysis. J Med Internet Res. 2018;20:e66.

    Article  Google Scholar 

  6. Centers for Medicare & Medicaid Services (CMS). 2019 Physician Fee Schedule and Quality Payment Program. 2018. https://www.cms.gov/newsroom/fact-sheets/finalized-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar. Accessed 13 Dec 2019.

  7. Sana F, Isselbacher EM, Singh JP, Heist EK, Pathik B, Armoundas AA. Wearable devices for ambulatory cardiac monitoring: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75(13):1582–92.

    Article  Google Scholar 

  8. Cheung CC, Deyell MW. Remote monitoring of cardiac implantable electronic devices. Can J Cardiol. 2018;34:941–4.

    Article  Google Scholar 

  9. Li J, Yang P, Fu D, Ye X, Zhang L, Chen G, Yang Y, Luo H, Chen L, Shao M, Li C, Liu Y, Zhou Y, Jiang H, Li X. Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomized controlled trial. BMJ Open. 2019;9:e023923.

    Article  Google Scholar 

  10. Dickinson MG, Allen LA, Albert NA, DiSalvo T, Ewald GA, Vest AR, Whellan DJ, Zile MR, Givertz MM. Remote monitoring of patients with heart failure: a white paper from the Heart Failure Society of America Scientific Statements Committee. J Card Fail. 2018;24:682–94.

    Article  Google Scholar 

  11. Artico J, Zecchin M, Zorzin Fantasia A, Skerl G, Ortis B, Franco S, Albani S, Barbati G, Cristalli J, Cannata A, Sinagra G. Long-term patient satisfaction with implanted device remote monitoring: a comparison among different systems. J Cardiovasc Med. 2019;20:542–50.

    Article  Google Scholar 

  12. Catalan-Matamoros D, Lopez-Villegas A, Tore-Lappegard K, Lopez-Liria R. Patients’ experiences of remote communication after pacemaker implant: the NORDLAND study. PLoS One. 2019;14:e0219584.

    Article  Google Scholar 

  13. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: ethical principles and guidelines for the protection of human subjects of research. Bethesda, MD: US Government Printing Office; 1978.

    Google Scholar 

  14. United States Food & Drug Administration. Device software functions including mobile medical applications. https://www.fda.gov/medical-devices/digital-health/device-software-functions-including-mobile-medical-applications. Accessed 13 Dec 2019.

  15. Walker RC, Tong A, Howard K, Palmer SC. Patient expectations and experiences of remote monitoring for chronic diseases: systematic review and thematic synthesis of qualitative studies. Int J Med Inform. 2019;124:78–85.

    Article  Google Scholar 

  16. Maher NA, Senders JT, Hulsbergen AFC, Lamba N, Parker M, Onella JP, Bredenoord AL, Smith TR, Broekman MLD. Passive data collection and use in healthcare: A systematic review of ethical issues. Int J Med Inform. 2019;129:242–7.

    Article  Google Scholar 

  17. Mittelstadt B. Ethics of the health-related internet of things: a narrative review. Ethics Inf Technol. 2017;19:157–75.

    Article  Google Scholar 

  18. Bierman AS. Functional status: the sixth vital sign. J Gen Intern Med. 2001;1611:785–6.

    Article  Google Scholar 

  19. Petersen C, DeMuro P. Legal and regulatory considerations associated with use of patient-generated health data from social media and mobile health (mHealth) devices. Appl Clin Inform. 2015;6:16–26.

    Article  CAS  Google Scholar 

  20. Thomson EA, Nuss K, Comstock A, Reinwald S, Blake S, Pimentel RE, Tracy BL, Li K. Heart rate measures from the apple watch, Fitbit charge HR 2, and electrocardiogram across different exercise intensities. J Sports Sci. 2019;37(12):1411–9.

    Article  Google Scholar 

  21. Turakhia MP, Desai M, Hedlin H, Rajmane A, Talati N, Ferris T, Desai S, Nag D, Patel M, Kowey P, Rumsfeld JS, Russo AM, Hills MT, Granger CB, Mahaffey KW, Perez MV. Rationale and design of a large-scale, app-based study to identify cardiac arrhythmias using a smartwatch: the Apple Heart Study. Am Heart J. 2019;207:66–75.

    Article  Google Scholar 

  22. Balthazar P, Harri P, Prater A, Safdar NM. Protecting your patients’ interests in the era of big data, artificial intelligence, and predictive analytics. J Am Coll Radiol. 2018;15:580–6.

    Article  Google Scholar 

  23. Faden RR, Kass NE, Goodman SN, Pronovost P, Tunis S, Beauchamp TL. An ethics framework for a learning health care system: a departure from traditional research ethics and clinical ethics. Hastings Cent Rep. 2013:S16–27.

    Google Scholar 

  24. Geis JR, Brady AP, Wu CC, Spencer J, Ranschaert E, Jaremko JL, Langer SG, Kitts AB, Birch J, Shields WF, van den Hoven van Genderen R, Kotter E, Jochoya JW, Cook TS, Morgan MB, Tang A, Safdar NM, Kohli M. Ethics of artificial intelligence in radiology: summary of the Joint European and North American Multisociety Statement. Radiology. 2019;293:436–40.

    Article  Google Scholar 

  25. Wang L, Alexander CA. Big data analytics in biometrics and healthcare. J Comput Sci Appl. 2018;6:48–55.

    Google Scholar 

  26. American Medical Association. Digital implementation playbook. 2018. https://www.ama-assn.org/amaone/ama-digital-health-implementation-playbook. Accessed 25 Dec 2019.

  27. National Institute for Standards and Technology. Securing the telehealth remote patient monitoring ecosystem. https://www.nccoe.nist.gov/sites/default/files/library/project-descriptions/hit-th-project-description-final.pdf. Accessed 25 Dec 2019.

  28. European Commission. Privacy code of conduct on mobile health apps. https://ec.europa.eu/digital-single-market/en/privacy-code-conduct-mobile-health-apps. Accessed 25 Dec 2019.

  29. American Heart Association. Using remote patient monitoring technologies for better cardiovascular disease outcomes guidance. 2019. https://www.heart.org/-/media/files/about-us/policy-research/policy-positions/clinical-care/remote-patient-monitoring-guidance-2019.pdf?la=en&hash=A98793D5A04AB9940424B8FB91D2E8D5A5B6BEB. Accessed 25 Dec 2019.

  30. Brahmbhatt DH, Cowie MR. Remote management of heart failure: an overview of telemonitoring technologies. Card Fail Rev. 2019;5:86–92.

    Article  Google Scholar 

  31. Noah B, Keller MS, Mosadeghi S, Stein L, Johl S, Delshad S, Tashjian VC, Lew D, Kwan JT, Jusufagic A, Spiegel BMR. Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials. NPJ Digit Med. 2018;1:20172.

    Article  Google Scholar 

  32. Shufelt C, Dzubur E, Joung S, Fuller G, Mouapi KN, Van Den Broek I, Lopez M, Dhawan S, Arnold CW, Speier W, Mastali M, Fu Q, Van Eyk JE, Spiegel B, Merz CNB. A protocol integrating remote patient monitoring patient reported outcomes and cardiovascular biomarkers. Digital Med. 2019;2:84.

    Google Scholar 

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Correspondence to Elizabeth A. Krupinski .

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Krupinski, E.A., Pagliaro, J.A. (2021). Remote Patient Monitoring: Delegation of Responsibility. In: Bhatt, A.B. (eds) Healthcare Information Technology for Cardiovascular Medicine. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-030-81030-6_3

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  • DOI: https://doi.org/10.1007/978-3-030-81030-6_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-81029-0

  • Online ISBN: 978-3-030-81030-6

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