Patient Investment in Remote Monitoring

Despite a consolidated team-wide effort, maintaining patient buy-in throughout their planned course of involvement in the program continues to be of concern. 

To ensure that patients are well informed regarding the benefits and potential challenges of daily monitoring from home, primary care providers explain the process to patients in office, when the initial recommendation is made.  During installation, the RNCC and Team Care Assistant follow-up on this information, targeting other potential challenges that may arise during the home visit, and repeating the reasons for referral. 

Although there has been much success in the program thus far, patients occasionally agree to participate in the program only to request equipment removal in a short amount of time – as little as two days, in some cases.  There are a few possible explanations that we have seen thus far.  Patients may simply agree to participate when it is recommended by their PCP in the office, viewing their PCP as an authority to whom they should comply, but re-thinking it when the reality of the program sets in.  Even with authentic buy-in initially, the demand of maintaining a consistent schedule and taking readings when necessary could pose too troublesome of a challenge.  Patients also may not be emotionally prepared to see their own readings each day, triggering anxiety and feelings of hopelessness when faced by the experience of daily weight or blood sugar checks, for example. 

Each case presents a different outcome, sometimes resulting in the early removal of a specific instrument or all equipment from the patient’s home, and other times with the patient retaining the equipment but refraining from using it regularly.  In the latter circumstance, keeping the instrument nearby may be a practical solution.  In the case that a PCP may unexpectedly require a specific reading, a simple phone call may be made to request that the patient comply at that time, even though readings are not taken daily.  Such a compromise may be a logical way for the program to continue to assist in the monitoring of patients who are not fully invested.