Is remote care the future of preventive care?

Alexandria Foley: ©Brook Health

Access to health care is in crisis and it’s getting worse.

The 2024 Philips Future Health Index, a global survey of 3,000 health care leaders in 14 countries, encapsulates the problem. Among the findings:

• 81% of leaders said delays in care are an issue at their organization, whether due to longer waits for appointments and treatments, or reduced access to services
• 69% reported increased waiting lists for appointments
• 62% said time with patients is reduced
• 49% reported a decreased capacity to meet the needs of underserved communities

The causes for lack of access in the U.S. are many: a growing shortage of clinicians, particularly at the primary care level; rural hospital closings; health care system mergers; barriers presented by social determinants of health (SDoH) such as poverty, food scarcity, lack of transportation, housing instability; and more.

Decreased access to care and resources hurts community health at large as well as individual patients, particularly those with chronic conditions who require more care overall, including monitoring, education and reinforcement of treatment plans. Accessibility for specialty care is also impacted, where wait times can be even longer for initial visits, consultations and follow-up care. Shortages of specialty clinicians in rural parts of the country make it even harder for a big part of the population to get the care they need.

The lack of access, particularly at the primary level, is delaying health care’s long-awaited switch to value-based care, a model largely built on enhanced primary and preventative care. It calls on primary care providers (PCPs) to take a more active role in their patients’ health, not only treating specific conditions and illnesses but guiding them on a path toward wellness.

With access to routine, specialty and emergency care already restricted, improving preventative care can seem like a lower priority. In fact, maximizing preventative care should be a top goal because it improves outcomes, reduces the demand for more urgent care, saves money and relieves the burden on primary care practices and organizations.

But how to improve preventative care? The country is not miraculously going to be able to add the tens of thousands of additional PCPs it needs or double the capacity of current providers. The answer lies elsewhere. Specifically, it can be found in remote care services, including remote patient monitoring and chronic care management, both of which can offer opportunities for early intervention and reduce the need for in-person visits, unnecessary hospitalizations or emergency department visits, freeing clinicians and staff from non-critical and routine tasks to provide needed care.

How remote care helps

The adult population with chronic diseases is growing. In most cases, these patients require monitoring and preventative care to keep their conditions from worsening. However, the burden of checking for and reporting worsening symptoms often falls to the patients themselves. Remote care makes it possible for clinicians to check on these patients and detect abnormal patterns that patients might miss, allowing for early intervention.

Traditionally, much of preventative care has required in-person visits with a provider, which can be difficult to schedule. Long intervals between appointments and tests increase the chances that a patient’s condition will worsen, requiring more intensive care. Regular remote monitoring of key health indicators, such as glucose levels for patients with diabetes, identifies problems before they become serious, allowing providers to intervene in time to stave off an emergency.

Remotely monitored patients become active participants in their care. Rather than being involved only when they’re at the doctor’s office, or experiencing symptoms, they can access their data through patient portals and mobile apps from remote care partners. The regular feedback and constant generation of data makes them more of a collaborator in their own care and can encourage them to make better choices about their lifestyles and health.

Remote care allows providers to develop personalized goals associated with their treatment plans that are integrated into care plans for patients based on their individualized needs and data obtained. A tailored plan makes it easier for providers to deliver targeted adjustments and interventions to these plans based on real-time information delivered through remote devices. Medication and treatment can be modified as soon as it’s needed without waiting for an annual appointment or medical crisis.

And the benefits aren’t limited to patients. With time-intensive monitoring delegated to a remote care partner, overworked and undermanned primary care offices will become more efficient and able to focus on providing in-person care. Increased preventative care delivered remotely will result in better overall health for the patient base.

In addition to improving outcomes for patients, early detection through remote care saves health care providers money. Preventing the worsening of a disease is less expensive than treating it. For example, intervening when a remote monitor identifies signs of fluid retention in a patient with congestive heart failure (CHF), a provider managing the patient in the office or at home is more cost efficient than treating the patient for a CHF exacerbation in the hospital because it requires far fewer resources, including provider time, medical equipment, a hospital room, potential complications, etc.

The human touch

Those who don’t understand modern remote care sometimes dismiss it as “medicine by machine,” little more than monitors checking vital signs and feeding data into a distant computer. In fact, remote care can be more personal than occasional in-person care. Nurses and other staffers at remote care companies regularly interact with patients, educating them about their conditions, answering their questions, responding to alarms and providing encouragement.

The bond they can form with their remote caregivers can incentivize patients to take better care of themselves, just knowing that someone is checking the information and will be “watching” over them. Ideally, remote care company nurses should be in the same community as the patients they monitor. This allows them to connect disadvantaged patients to local resources, such as transportation services, food banks, translators, etc.

Providing remote care through a trusted partner is an effective way for primary care practices and providers to deliver preventative care to patients, relieve the problem of access and reduce the demand for their services.

Alexandria Foley, MSN, RN, is VP of Nursing and Care Delivery at Brook Health.