This interview has been edited for length and clarity.
In the inpatient setting, care teams have constant access to their patients. But, once people leave the hospital, it can be challenging to understand their care journeys and ensure they stick to treatment plans.
How can digital health innovations bridge this care gap?
In this episode of the Memora Health Care Delivery Podcast, our guest James Cireddu, MD, FCCC, Medical Director of Harrington HVI at UH Regional Bedford and Richmond Medical Centers and founder of VPExam, explains why telemedicine falls short of delivering high-quality care, how remote patient monitoring (RPM) can improve, and where AI can help bridge gaps.
Telemedicine is a revolutionary tool — but it has its limits
Telemedicine saw its star rise during the pandemic. In response to an unprecedented public health emergency, providers everywhere quickly adopted this technology to maintain their responsibilities to their patients.
But, since its peak during the height of COVID, the limits of telehealth have become apparent.
One drawback to virtual doctor visits is a lack of immediate physical proximity. This is especially apparent when it comes to managing chronic and complex disease. Dr. Cireddu remarks, “We’ve all become more familiar with telehealth … but for cardiology, the physician exam is really critical … In heart failure, we are adjusting very powerful medications. If we don’t understand what’s going on physiologically, we’re flying blind.”
That could be one reason for a recent decline in its use. However, another factor preventing its continued expansion very well could be patient preference for in-person visits.
Dr. Cireddu explains, “There’s almost a recession of the adoption of telemedicine. A lot of people used it [during COVID] because there wasn’t a lot they could do. You want patients to come to your clinic, so using telemedicine made more sense than seeing nobody. [But] patients would rather see [doctors] in-person most of the time, because they think they’re losing a lot with telemedicine.”
That’s why forward-thinking digital healthcare innovations increasingly complement in-person care, providing actionable symptom and treatment support outside of the four walls of the hospital — ultimately helping deliver high-quality, high-touch care at home.
Remote patient monitoring needs to integrate with care team workflows to be effective
To keep tabs on the physical well-being of patients, providers have used RPM devices to monitor important metrics and understand patient statuses away from inpatient settings.
However, when it comes to complex conditions, RPM becomes challenging. Calling out cardiac care management specifically, Dr. Cireddu remarks, “[Heart failure] is the number one cause of hospitalization for patients over 65. It’s costing over $43 billion per year … There’s a lot of complex medications that don’t just impact the heart. They impact the kidneys. They impact the liver. And we have to constantly monitor all of that.”
Taking time to review and organize this complicated data can be burdensome for care teams and hinder care coordination. On top of that, most RPM technologies fall short of fully integrating with clinician interfaces. Dr. Cireddu adds, “One of the problems with remote patient monitoring is … if the physician isn’t involved, they’re not documenting that they reviewed the data and they’re not utilizing it to change care management ... I’ve seen a lot of excitement around remote patient monitoring, but actually getting it into the physician workflow is a big challenge.”
Novel healthtech innovations seek to streamline clinical workflows and provide care teams with highly efficient modes for receiving and reviewing patient data. Ultimately, laser-focusing on supporting providers to effectively use this information could lead to improved RPM operations and better outcomes.
AI holds a lot of promise for helping healthcare utilize its data
There’s no question that AI has gained steam over the past year. So the general conversation surrounding AI in healthcare has shifted away from if it will play a critical role in healthcare to how it can help.
Dr. Cireddu strongly suggests that AI will assist — not replace — clinicians. He says, “I think everybody’s excited about the potential for artificial intelligence. Some people ask, ‘Is that going to push some providers out of medicine?’ I don’t think so.”
Where AI can support providers the most, he proposes, will be in organizing data and connecting it to implementing effective care delivery. Specifically, it could significantly simplify patient prioritization. Dr. Cireddu adds, “AI can tie [more] different data points together than we can now … AI can help a lot with triaging, and getting the sicker patients with these red flag warning signs to their cardiologist, a new cardiologist, or someone on their cardiologist’s team a lot quicker.”
“AI can help a lot with triaging, and getting the sicker patients with these red flag warning signs to their cardiologist, a new cardiologist, or someone on their cardiologist’s team a lot quicker.”
- James Cireddu, MD, FCCC, Medical Director of Harrington HVI at UH Regional Bedford and Richmond Medical Centers and founder of VPExam
Intelligent care enablement technologies like Memora Health leverage AI to flag alarming incoming patient messages and automatically notify the correct care team member for immediate attention.