Home Telemonitoring

It is a little past the hype stage, out of which it crept with head held low, but remote telemonitoring of patients at home continues to press on and a new piece of research suggests it may improve some outcomes, but does not clearly reduce costs.   (Telemon. Report)  The study was conducted among 208 patients assigned to either usual care or usual care plus home telemonitoring.  The patients were all from the Mayo Clinic, were in relatively poor health, over 65 and the usual care and intervention groups had similar baseline characteristics.  The intervention included a piece of telemonitoring equipment which reported a number of health measurements and nurse intervention depending on the results of those measurements.  After enrollment, average mean annual cost for the usual care group was $28,776 and for the telemonitoring cohort was $$19,239; but the high variability of spending within each group and the relatively small number of patients in the experiment meant the result was not significant.

Comparing post-enrollment to pre-enrollment spending, however, for the telecare group it dropped by $2,467, largely due to lower outpatient spending, but rose in the usual care group by $4836, mostly because of higher inpatient spending.  The annual cost of the intervention was estimated at $837.  The telemonitoring group actually had more 30 day hospital readmissions than the usual care one, but the cost of those readmissions was far lower than for the usual care group, which might indicate that the providers became aware of the need for a hospitalization more quickly with monitoring and therefore treated the patient before he or she became significantly more ill.  And costs may not be lower because monitoring could keep people from dying as often and they are then alive longer to incur more spending. The study actually indicates that telemonitoring can be helpful and a larger study, and one that looks more closely at treatment changes resulting from telemonitoring might in fact show positive spending effects.