Remote Patient Monitoring: What Does the Future Hold?

Hi, I'm David Armstrong. I am professor of surgery and I direct the Southwestern Academic Limb Salvage Alliance, or SALSA, at the Tech School of Medicine at the University of Southern California, in beautiful, sunny southern California.

We have had a really significant interest in this area in measuring and managing how people move through the world for the longest time. And RPM, or remote patient monitoring, has been the end goal for the longest time. And what is so cool now is to see how this has just taken off like crazy. And for us now, the ability to communicate with our patients and to be able to do that, creates the ability for us to feel like we're doing something with them and not to them, if that makes any sense. And that has been the biggest single advantage of using RPM as it were. And there are many different kinds in this area, and we've probably played with virtually all of them.

We have a bunch of things going on right now. And I think monitoring our patients that have healed their diabetic foot wounds ... And you know that once someone is healed, they're not healed. We use the term remission because 40% will recur at one year, two-thirds of three, three quarters at five. So if we can extend those ulcer-free days and hospital-free days, then that's how we can make a difference. And RPM, remote patient monitoring, has really helped us do that. And whether that is a smart bath mat, whether that's a smart sock, whether that is a smart insole, whether it is a passive monitoring tool in the house, even a smart carpet, whether it is a foot selfie program that we put together, or many other types of similar projects, they've all been pointing in one direction, which is helping us communicate better with between clinician, patient, family, and also other members of the medical table.

One of the other things we're doing right now is we have a really fun NIH-sponsored randomized control trial where we are using a smart boot. And we are using both a smart boot, the equivalent boot without the smarts that's removable, and then an irremovable boot on patients with diabetic foot ulcers, and we're following patients to healing. But in that study, it's really been fascinating because what we've been finding is that if we give people information like," Hey, you're doing great," or, "Hey, that device isn't on you as much as it could be, and maybe you're not being as adherent as you could be," we thought that was going to be really helpful at first, but it looks like we might be wrong. It looks like either it takes a few weeks for our patients to catch on and for that to be helpful or maybe the information coming back to the doctor or nurse and then the weekly discussion with the patient may be the most helpful aspect. We don't know which it is in that study that is being most effective.

But this is too much to discuss now in our chat together today. But man, that is a data-rich environment and it is fascinating. It is an answer-rich environment, we think pretty soon, which is exactly what we want from that NIH study.