Since healthcare reform has been a big part of both presidential candidates' platforms, perhaps part of the incoming president's plans should be to get behind policies that would promote remote patient monitoring.

According to a new study by economist Robert Litan, remote patient monitoring could be the key in cutting healthcare costs by nearly $200 billion in the next 25 years – if it were used to track the vital signs of patients with chronic diseases such as congestive heart failure and diabetes.

The report, titled "Vital Signs Via Broadband: Remote Health Monitoring Transmits Savings, Enhances Lives," was released late last month at a press conference in Washington held by AT&T (San Antonio) and Better Health Care Together (Washington), a nonprofit consortium that promotes healthcare reform. Both agencies funded the research that led to the development of the report.

"Remote monitoring can spot health problems sooner, reduce hospitalization, improve life quality and save money," Litan said in a statement regarding the study.

Remote monitoring involves equipping patients with devices such as heart and blood pressure monitors or blood glucose meters, then transmitting meter readings to a healthcare center that tracks the data. The goal is to spot problems as they develop and take steps immediately, rather than waiting for them to become crises.

And those steps translate into savings that would come primarily from reducing emergency room visits, hospitalizations and lengthy hospital stays.

Remote monitoring enables caregivers, via computerized data centers, to be alerted in real-time, seven days a week of vital sign changes that could be medically significant. The alerts enable earlier intervention to help patients before they are seriously ill. Without remote monitoring, caregivers must depend on notification from patients who may not report changes until physical symptoms are dramatic and more challenging to resolve.

Litan said there is a small window of opportunity to realize the full potential of the savings. He added that adoption of remote monitoring and other telemedicine opportunities will be slowed and benefits reduced unless the U.S. does a better job of reimbursing healthcare organizations for remote care and encouraging continued investment in broadband infrastructure that can be tailored to meet the privacy, security, and reliability requirements for telemedicine applications.

Also, failure to make the right policy changes and adjustments will cut estimated healthcare savings by almost $44 billion throughout the 25-year period.

Some of those policy changes would include stronger broadband connections that are highly reliable and secure and give critical medical transmissions priority in the event of data traffic jams.

He also called for more broadband deployment throughout the U.S. and policy changes, particularly in the area of reimbursement for remote monitoring. Although healthcare providers are paid for telemedicine when it involves two-way video consultations, they are not paid for monitoring patients' conditions preventively.

Some companies already are moving to the forefront to provide this kind of service.

SwiftMD (New York), a telemedicine company staffed exclusively with board-certified emergency medicine physicians, was formed in earlier this year by Elliot Justin, MD (Medical Device Daily, Sept. 29, 2008). Justin told MDD that he came up with the idea after a day on the job seeing several patients who didn't really need to be in the ER, but had spent hours waiting to be seen after being told by primary care doctors that they should go to the ER and even have unnecessary tests.

An April report by the Institute of Medicine (Washington) cites health information technology, such as interoperable electronic health records and remote monitoring, saying that these technologies can be used to support the healthcare workforce by improving communication among providers and their patients, building a record of population data, promoting interdisciplinary patient care and care coordination, facilitating patient transitions, and improving quality and safety overall.

"Hospitals and doctors can't provide services unless they get paid. We need insurance reimbursement policies, beginning with Medicare and Medicaid, that cover remote monitoring," Litan said. "We also need policies that deliver broadband, including 'smart networks' that ensure that patients' critical data is secure and that communications are not disrupted."