Remote Patient Monitoring (RPM) is widely seen as one of the most significant advancements in modern healthcare, reducing inequalities and barriers to care and vastly improving the speed of responsiveness to lower preventable hospitalizations, readmissions, and fatalities through consistent, ongoing patient monitoring. And it has a very interesting history.
The first seeds of innovation were planted as far back as 1924. While the telephone had, at that point, only been around for less than 50 years and lacked the functionality to be used for widespread communications, the Radio Times magazine speculated about how the radio might, at some point, be used to provide medical consultations.
It took another 24 years for the first instance of documented telehealth to occur. Still, as the benefits become better known, RPM has emerged as a concept that has been rapidly adopted across the present-day healthcare system.
A Timeline of the Development of RPM and Virtual Telehealth Services
We’ve mentioned the first inkling within the media that digital medical consultations would become a reality. This idea was realized when practitioners working in Philadelphia, USA, sent some X-rays from their radiology department via phone wire to another doctor to review.
The images only travelled 24 miles – but they did so through a telephone line in a first-of-its-kind experiment.
Clinicians recognized the benefits of being able to consult other peers and specialists in their field in this way.
By the late 1950s, physicians were regularly sending neurological scans and medical files to experts to help with diagnoses and evaluations.
Shortly after, in the 1960s, psychiatric professionals joined the movement and started using closed-circuit TV, commonly known as CCTV, to provide consultations.
The Intersection Between the Space Race and RPM
With the groundwork already laid, virtual healthcare took another significant leap during the 1960s, primarily because of the need to manage the welfare of astronauts circling the Earth’s atmosphere. NASA integrated technology into a microphone to monitor Alan Shepard, the first American person ever to visit space.
They combined a thermometer, an early version of an EKG monitor, and a respiratory sensor to help analysts record biological data to ensure Shepard remained fit and well during orbit. They then added a blood pressure monitor, giving other healthcare professionals a better idea about how this patient monitoring method might work over much broader distances than before.
From 1967 onward, physicians would routinely send EKGs through telephone wires, while the first documented RPM program – for everyday patients rather than cosmonauts – was introduced in Arizona at the Papago Indian Reservation.
Although the program would fall foul of various problems and last just seven years, NASA extracted the learning from the project to improve its own technology.
By the 1980s, medical professionals began using similar communications systems to share X-rays, followed by the first iterations of wearable tech developed in 1982. Athletes could wear a biometric watch, a less advanced version of today’s FitBits and Whoop bands, with a chest strap that measured heart activity.
How the Evolution of the Internet Made RPM Possible
In January 1983, the way the world communicated was about to change dramatically and forever when the internet came into existence. The first-ever web browser was launched ten years later, in April 1993.
The airline industry saw the applications for digital communications quickly and started introducing wireless internet connections for airport users, with the initial Wi-Fi system called Apple Airport. Others followed, with a type of Wi-Fi connection supported by Windows and then the first router in 2001.
While today we use Bluetooth for everything from playing music in our cars to asking Alexa to turn on the lights, when it first came about in 2000 as an innovative type of short-range tech, it was a game-changer in how devices and applications shared data.
Sluggish dial-up internet connections were replaced with broadband in the early 2000s, with around half of all connections switched to broadband by 2007.
These changes happened seemingly rapidly when compared to our earlier timeline. Still, much was due to the speed at which medical professionals could transmit readings, data, and complex medical charts – and the distance that information could travel while remaining intact.
By 2019, the CMS in the US had accepted the need for RPM services on a much wider scale and decided to review CPT codes to allow practitioners and medical services to start claiming for virtual care services through the various Medicare care management systems.
COVID-19 and the Surge in Demand for RPM
Take-up of RPM services in the late 2000s was slow despite the positive outcomes displayed by those adopting RPM technology at this stage. However, when the COVID-19 pandemic hit in 2020, everything changed.
Healthcare industry decision-makers need to react fast to a global crisis while finding ways to introduce continuity of care for those affected by the virus, patient demographics in at-risk categories, and other vulnerable proportions of the population, such as patients living in assisted care and residential facilities.
The US government responded by substantially expanding the availability of remote patient management solutions, leading more and more healthcare providers, public and private, to turn to RPM and telehealth to either replace services they could not deliver or augment practitioner and patient safety without putting patient welfare at risk. In 2020, over 23 million patients across the US used RPM services.
How Will RPM Evolve Into the Future?
Analysts anticipate that within the next year, the volume of patients in the US accessing healthcare via RPM will increase to 30 million – with the global market forecast to reach a valuation of over $1.7 billion by 2027. You can read more about RPM statistics here.
As a concept that is now well established, functional, and tested in real-world scenarios, we can see that, even though RPM might appear to be a novel healthcare approach designed due to the pandemic, it has been in development for decades.
Changes to global populations, not least high average ages and longer lifespans, coupled with a growing prevalence of chronic healthcare conditions, seem incredibly likely to mean demand will only continue to grow.
Practitioners need to find ways to expand capacity and access to care, often without a comparable increase in time or financial resources – making RPM an ideal solution that is designed for rapid implementation.
While we can't know for sure what the world of healthcare will look like in ten or even 50 years, it seems certain that digital access to healthcare and the corresponding cost efficiencies mean RPM is here to stay.