Author Insights: Home Telemonitoring Does Not Reduce Hospitalizations or Emergency Department Visits for Seniors

Paul Y. Takahashi, MD, MPH, an associate professor of medicine at the Mayo Clinic in Rochester, Minn, and colleagues found that tracking older patients at home through telemonitoring did not lead to fewer hospitalizations or emergency department visits. (Image: Mayo Clinic)

A telemonitoring device in the home that can measure and transmit information about indicators of health such as blood pressure and oxygen saturation coupled with videoconferencing can allow a health care team to assess a patient’s condition remotely and discuss ongoing treatment plans with the patient. Proponents of telemonitoring suggest that it has the potential to improve patient outcomes, but recent studies suggest such optimism may be premature. New findings appearing in the May 28 Archives of Internal Medicine found that telemonitoring of older adults with multiple health issues did not reduce hospitalizations and emergency department visits.

The findings are based on a study of 205 individuals with an average age of about 80 years and multiple chronic conditions who were randomly assigned to receive telemonitoring or usual care at 4 Mayo Clinic sites in Minnesota. After 12 months, the researchers found no difference in rates of hospitalization or emergency department visits between the 2 groups.

Paul Y. Takahashi, MD, MPH, an associate professor of medicine at the Mayo Clinic in Rochester, Minn, discusses his team’s findings:

“It’s really important to try to change our care models offered to older and sicker patients. Taking care of older people to help keep them out of the hospital is important because every time they go, they usually lose a little more of their health. We looked at this population and thought using a monitoring system and taking measurements every day would help these patients avoid the hospital. Unfortunately, we did not find that. We still have to figure this out.

“Telemonitoring is designed to provide access and help people living in rural areas where they can’t easily just get up and go visit their doctor or a specialist. Maybe telemonitoring is not as important in Rochester [Minnesota, where the study took place] or other urban areas, where patients have easy access to their doctors. So maybe we need to look at different populations than the one we studied. Maybe the sickest population is not the right population. Maybe it’s those not quite as ill for whom you can make changes in treatments that will make a real difference.

“Telemonitoring will become a bigger part of medicine because the technology continues to grow, but the question is when is the appropriate time to use it. You want to make sure the time you’re investing in something is really helping. We do a lot in medicine because we think it is the right thing to do, but it might not be.”

Categories: Aging/Geriatrics, Telemedicine