When the COVID-19 pandemic caused a global lockdown, healthcare providers were forced to find new ways to provide care. This crisis quickly turned into an opportunity to take advantage of advances in remote patient monitoring (RPM) technology, which quickly became an important tool to help patients with diabetes and related chronic diseases stay in touch with their care team in a safe and comfortable home.

RPM technology includes platforms, devices, and tools, and is mainly used to collect patient-generated or device data about drug use or patient behavior. For diabetic patients, the main purpose of the RPM solution is to continuously observe, report, and analyze clinical indicators (for example, self-monitored blood glucose {SMBG} readings), insulin injections, and other patient behaviors, such as medication use, physical activity, and food intake . Providers can then use this information to initiate personalized, timely interventions, such as adjusting treatment plans, telemedicine guidance, or other patient participation activities.

To optimize care, the RPM platform also helps to share data from multiple sources among doctors, clinicians, payers, and patients, including electronic medical records, insulin delivery devices, and patient health/fitness equipment. They are especially valuable for patients at home or in rural areas where there is no easy access to the clinic.

In today's technology-saturated world, the vast majority of healthcare providers and patients immediately adapt to and accept the new normal of remote care services. For example, after the United States and many European countries implemented blockades, digital health company Glooko found that remote uploads on its RPM platform had increased by 32%.

"Our customers have found that RPM solutions are very useful and effective in managing the care of patients with diabetes and related chronic diseases," said Mark Clements, MD, pediatric endocrinologist, clinical researcher and chief medical officer at Glooko. "By combining regular remote monitoring of patient data generated throughout the day with weekly or biweekly telemedicine guidance, patients can achieve better health outcomes."

Clinical evidence confirms this claim. Since the 1990s, blood sugar control (ie, maintaining blood sugar levels within a certain range) has been the Rosetta stone for diabetes management. In a recent real-world study, diabetic patients participating in the RPM pilot program in the U.S. healthcare system used a diabetes management mobile app to synchronize blood sugar, medication, and lifestyle information. The RPM nursing team regularly remotely monitors these data and provides telemedicine guidance as needed. When the researchers compared the results of the study with the SMBG data collected at the time of enrollment, they observed immediate and continuous improvements in various blood glucose results for up to a year.

Although self-care is essential for maintaining blood sugar control, it is a full-time job for patients who have to measure their blood sugar levels multiple times a day; track, record, and titrate (ie adjust the dose) their insulin use; and track And record behavior, mood, and food intake. In a randomized clinical trial, an RPM platform with an app-based self-titration tool analyzed fasting blood glucose levels and recommended insulin dosage adjustments based on the doctor's pre-configured treatment guidelines.

Although patients using the app and patients in the control group had significantly improved blood glucose control after 16 weeks, the group using the self-titration app showed a greater proportion of SMBG readings within the target range of 70-180 mg/dL, and high SMBG readings Less (> 250 mg/dL), which may put them at greater risk of disease progression.

"These and other RPM studies demonstrate what can be achieved when patients have better self-care tools and information and providers can obtain clinically relevant information in a timely manner to quickly initiate required interventions," Clements said. "Obviously, combining various RPM solutions with traditional office care may have beneficial results."

To be sure, RPM and other home digital health innovations will eventually become part of the standard of care for diabetes and other chronic diseases.

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© 2019. This work has been licensed by CC-BY-NC-ND.

Our vision at Glooko is to be the basis for diabetes care decisions and to improve the quality of life of diabetic patients.

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