Helping Patients Help Themselves: The Added Benefits of Remote Patient Monitoring to Home Health Care

The Johns Hopkins Home Care Group (JHHCG) developed standard protocols for management of patients with chronic heart failure (CHF) and chronic obstructive pulmonary disorder (COPD) in an effort to improve patient outcomes and reduce preventable hospital readmissions. JHHCG implemented Remote Patient Monitoring (RPM), a telemonitoring program customized for the CHF/COPD patient that provides real-time, daily reporting of qualitative and quantitative data as well as patient education/reinforcement. Patient data is trended on a web-based program and overseen by the Disease Management Nurse. Emerging trends are easily identified, allowing for early and appropriate intervention. This program sets itself apart because of the constant communication and aggressive management of the patient as a team (patient, RPM disease manager, field nurse, and physician). Key to the success of home care and RPM is access to and collaboration with a responsive, managing physician that oversees the patient based on their plan of care.