Is remote-monitoring home care reducing ER visits?

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  • @dimitrydavydov says:

    Hi Paul: You wrote that “OTN is now turning its attention to smartphone apps”. Please, could you clarify, how you assess “their real value to patients”? I work with a doctor on implementing mHealth app in Workers’ Compensation service in California. We have only generic information about scientific validity of some technologies in this area to detect health changes (improvement and impairment), but not ad-hoc info of value in this specific service. Do your conduct trials with all “100,000 apps related to health-care” or have adhoc selection criteria?

    Thank you.

    • Paul Taylor says:

      The Ontario Telemedicine Network is in the early stages of evaluating apps. You would need to connect directly with OTN if you want more detailed information about the methodology. The website is

  • ebrown @ OTN says:

    Please re-read the study again!

    The study randomized patients and enrolled everyone in the intervention group into the program, regardless of whether they judged to be interested and engaged candidates or not. Most of the enrollees did not adhere to the basic intent of the study – monitoring or coaching – and hence had no opportunity for behavior change. The whole point of this kind of intervention is to engage, educate and motivate patients to improve their behaviours and self-management skills.

    HOWEVER, the sub-set of patients that did engage in the monitoring and coaching had excellent results. Here is the relevant result:

    “Individuals with better adherence to monitoring—defined as greater than 50% of days monitored—had a significantly lower rate of hospital readmissions at 180 days compared with those who monitored their weight, blood pressure, heart rate, and symptoms on less than half of the study days (41.3% vs 61.1%, respectively; P<0.001). Similarly, mortality at 180 days was significantly lower among heart-failure patients who completed more telephone calls with the nurses (>50% of calls completed) and monitored their risk factors and symptoms more diligently (>50% of days monitored).”

    • @cmaer says:

      Thanks for your comment and noting the fact that those who actually participated did significantly better.

      I’m very enthusiastic about the work you are doing. Wrote this feature a year ago:

      • Paul Taylor says:

        Hi Pat:

        I am glad Dr. Ed Brown was able to shed some light on that latest U.S. study — and point out how the situation here in Ontario is different.

        Thanks for sharing the link to the feature you wrote. The more information, the better.

      • ebrown @ OTN says:

        Hi Pat

        Great article – I hadn’t seen it before.

        Bottom line for me – I think we are seeing more and more evidence showing that if we can engage, educate, empower and motivate people living with chronic disease to self-manage and make the lifestyle changes they need, we will see dramatic results.

  • @cmaer says:

    Very timely that the large BEAT-HF telemonitoring trial for chronic heart failure just released at the AMerican Heart Association conference in Orlando failed to show a reduction in hospitalization rates compared to usual care.

    Shows the importance of rigorously controlled trials.

    Reasons for lack of impact may have been dated nature of the technology (circa. 2011) and some real issues around engaging patients to actually participate and use the technology


Paul Taylor


Paul Taylor is a health journalist and former Patient Navigation Advisor at Sunnybrook Health Sciences Centre, where he provided advice and answered questions from patients and their families. Paul will continue to write occasional columns for Healthy Debate.

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