Island Health Expands Its Remote Patient Monitoring Strategy

Because the remote patient monitoring landscape is so new and innovative, healthcare providers are approaching the space with a wide range of strategies. On Canada’s Pacific coast, one health system has launched a program that aims to include as many patients as possible.

Island Health, on British Columbia’s Vancouver Island, has an RPM program in place that caters to the patient. The government-funded, $42 million program screens patients for exclusion, rather than inclusion, and assigns mHealth devices and care team coverage based on that patient’s care management needs.

“We basically have it open to anybody,” says Sean Spina, PharmD, director of special projects at Royal Jubilee Hospital and the Hospital at Home Program’s research leader.

The program takes a different approach than others in the US and Canada, many of which look to identify specific patients or populations to monitor, assign the appropriate devices and establish care benchmarks. At Island Health, the focus is on creating a home monitoring routine for the patient, with devices and data points specific to that patient.

Spina says the program was in place prior to the global pandemic, then put on hold for a while so that the health system could focus on COVID-19, but the Canadian province’s government asked that it be restarted. It was launched in November 2020 with a goal, as with others like it, is to take patients with acute care needs who would be in a hospital and create a care management plan for them in their own homes, thus freeing up hospital beds, reducing costly hospital treatments and boosting clinical outcomes.

It also adheres to the idea that people heal faster and better at home, where they’re more comfortable and apt to do things that speed up recovery.

“Very rarely have we heard that people don’t feel safe being cared for in their own homes,” Spina says. “People enjoy being at home. In a hospital, (they’re) just lying around in a bed waiting for life to happen, but at home (they have) a reason to get up.”

Among the more popular features of the program, he says, is a “virtual call bell,” a wireless device originally suggested by patients. Similar to the bedside call button in a hospital, it allows patients to connect immediately with a care provider.

Patients feel more comfortable knowing they can summon help at a moment’s notice, he says.

The program begins at the hospital, where patients brought in for acute care are evaluated and asked if they want to take part. If they meet the criteria, which include evaluations of their care needs, home environment, ability to move around at home and access to caregivers, they’re given the appropriate devices, a tablet and the virtual call bel and sent home. Home visits are arranged at least one a day with the appropriate care providers and are based on each patient’s needs.

This includes medication management, an often overlooked function in an RPM program. Pharmacists are part of that routine, ensuring that prescriptions are being followed at home and that they’re doing what they’re supposed to be doing.

“Medication therapy is a mainstay of treatment,” Spina points out.

The program - which more than 96 percent of patients surveyed said would recommend to family or friends - takes aim at a fundamental challenge facing healthcare providers all over the world. Healthcare needs are changing, driven in part by emerging technologies and consumer preferences, so that hospitals are no longer the preferred place for care.

The adoption of RPM programs surged with the pandemic, which forced providers to find ways to reduce in-person care and take as many services as possible out of the hospital, doctor’s office or clinic, but it didn’t necessarily start with COVID-19. And as this crisis wanes, health systems will be continuing to look at ways to push care into the home.

Spina notes that programs like Hospital at Home are enabling the hospital to change its mission and to redefine care. In the future the health system will be the care manager and coordinator, supporting patients on their health journey and offering services and resources, and being a destination for in-person care only when it’s needed.

“We have to be open to what’s coming down the road,” he says.

Spina expects the program to evolve as providers become comfortable with the routines and the technology improves. He anticipates that more patients will be candidates for RPM programs, and those programs will encompass more services and more care providers. In time it will be part of the process, a natural pathway not only for episodic but long-term care.

“This right now is a whole different way of thinking how we deliver care,” he says. But in time it will more or less define how care is delivered.