Design and development of a disease-agnostic remote patient monitoring typology and associated tools

Abstract

Remote patient monitoring (RPM) expanded dramatically during the COVID-19 pandemic and continues to be implemented. However, no standardized method for classifying them exists which has implication for comparative evaluations. Our goal was to design and develop a disease-agnostic RPM typology tool as a first step towards a standardized approach for understanding and implementing RPM programs for different clinical use-cases. Guided by the Knowledge-To-Action framework, we conducted a rapid review of RPM programs from Canada, the United States, Europe, the United Kingdom, and Australia that were used to manage diabetes, chronic obstructive pulmonary disease, congestive health failure, hypertension, and COVID-19. We identified 87 articles to define common characteristics of real-world RPM interventions to enable comparison across different programs through pattern recognition, information mapping, and sensemaking. We extracted data with a macros-enabled Excel template. Design sessions with key stakeholders (researchers, clinical advisors, provincial RPM managers, and patient partners) provided iterative feedback on the typology and we defined a glossary of characteristics. The 12 most reported characteristics of RPM programs (including size, resources, monitoring team, data flow, alert protocol, workflow, and equity considerations) were clustered into four domains. Integration and equity domains were considered to exist on a spectrum from low-to-high- neither inherently superior to the other. 16 distinct RPM typologies were expressed through a 4x4 matrix (i.e., high or low on each of the four domains). Using this tool can inform insights on program maturity, implementation, and continued investments in RPM. We anticipate this typology will help new initiatives have greater potential to be robustly evaluated and sustained to scale. Future directions include further validity testing and exploring feasibility to systematically categorise real-world RPM programs with this tool.