Remote patient monitoring has ameliorated the clinical challenges posed by COVID-19, namely the increased risk of disease transmission, expanded the delivery of critical health information to otherwise excluded or disadvantaged communities, and rectified several issues involving the quality of care and patient satisfaction. As explained in a mixed methods study on digital health disparities, “engaging patients in effective self-care management and shared decision-making requires a well-informed patient. Increasingly, the needed health-related information and health decision-making guidance are packaged and made available digitally.”
But the acceleration of digital medicine is rendered meaningless without the proper patient involvement. Because many Medicare patients lack the necessary degree of technical literacy to operate their device(s) independently – a concern only augmented by advanced age – technical support is imperative.
Technical support must, principally, be rooted in a desire to help patients. Acting on one’s frustration with a patient’s failure to understand abrogates the integrity of the patient-provider relationship. Further, an effective support solution must reflect both the patient and the program.
Consider the Patient
Technical support is not a one-size-fits-all model. The specific needs of one patient are likely to vary from those of another. A support team must not only recognize a patient’s unique set of demands, but tailor their services accordingly. One framework that enables this individualized assessment is referred to as the social determinants of health, SDOH. The SDOH system identifies the environmental conditions involved in a patient’s social, mental and physical well-being.
The SDOH apply to virtually any avenue of health. For technical support, the following may be considered:
Communication:
Many patients experience communicative impairments related to vision, speech, and hearing. Such impairments may obstruct a patient’s ability to understand and recognize guides, instructions, and other support solutions. Once aware of an impairment, your support team should adapt their solutions to meet the patient’s needs. For instance, according to a study on communication improvement methods, “patients with hearing impairments, with or without hearing aids, may communicate in a variety of ways with health personnel. Some patients speak and speech-read or lip-read, some use sign language or communicate by writing notes, and some bring someone with them to interpret.” A patient’s communication requests should be noted and considered.
Beyond hearing impairments, other disabling conditions may be at play; as such, alternative support options must be available.
There are also certain practices used to alleviate stress on both sides of the patient-provider relationship. For instance, scheduling meetings and setups in advance has consistently reduced confusion. Scheduling may also allow a patient to enlist their health coach or physician – your support team can communicate with this individual to help with combinations.
If an impairment or disability is identified prior to shipment, you may be able to arrange for a ‘preassociation’ connection. In other words, you can set a patient up with their device(s) in advance to minimize their technical difficulties. Many patients may be given strictly cellular devices to cut down on setup complications.
Home environment:
A patient’s home environment also has a direct impact on their ability to apply and utilize technical support. Examples include but are not limited to apartments, houses, co-ops, multi-family homes, and multi-generational homes. If a patient is living with others, it may be worth chatting with another person (roommate, family member, etc.) to facilitate the process. If a patient is living alone, they may struggle to comprehend your instructions and advice. In this case, take the time to explain and reexplain the device set-up, application, and maintenance. Some patients may travel frequently or switch from one location to another. For such patients, it is important to prepare multiple support options depending on their setting.
Connection:
Not all patients have the necessary compatibility and connection to operate their device(s). This is often a product of a patient’s location. For instance, patients in rural environments or locations that restrict their access may be given strictly cellular devices.
Other considerations include internet connection, Bluetooth, and companion devices (iPhone, Android, etc.) Some patients may also require a pre-connected hub or tablet to store data.
Consider the Program
Following the assessment of a patient, your support team should similarly examine the selected program. Ask yourself the following questions:
Why is the patient receiving the device enrolled in the program?
How often should the patient use the device?
What are the different parts of the kit?
For instance, familiarize yourself with the cuff, monitor and USB adaptor in a blood pressure kit.
What are the device rules and instructions?
What are the included guides and inserts?
Does the device require Bluetooth, internet connection, cellular data, or additional connections?
Does the device require companion devices (iPhone, Android, etc.)?