Konzeptionierung einer neuen digital gestützten Versorgungsform auf Basis von Remote Patient Monitoring unter Einbeziehung innovativer Messverfahren

Demographic change represents an increasing social challenge. Due to the associated increase in the average age of the population, medical needs are also growing, while there is a shortage of medical personnel, especially in rural regions. Digital solutions such as Remote Patient Monitoring (RPM) can provide a solution. Here, the patients independently record their vital signs and transmit them to their physicians for review to support treatment. Such transmission of vital data in combination with AI-based analysis could pave the way for a completely new data medicine.
In this paper, the concept of a new digitally supported form of care based on RPM is presented from three perspectives: as a process, from a physician's perspective, and as a technical model. This concept is further enriched by the inclusion of innovative vital signs and their measurement methods. The focus here is on non-invasive measurement as well as continuous measurement with wearables.
In the course of the book, the aforementioned technical model is mainly considered. Here, the patients are prescribed to measure selected vital signs by their attending physician, depending on the indication. After an initial set-up of the devices, the patient independently measures the vital signs. If necessary, nursing staff can provide support here. The best place to store health data is the electronic health record (EHR), where it is stored for the patient's entire life. Furthermore, thanks to extensive interoperability specifications, both physicians and researchers can access the data. To store vital data there, it can be transmitted from the meter to a smartphone via Bluetooth, and forwarded to the ePA via a digital health application. AI-based analysis and evaluation can take place on the ePA data, and the analysis results can in turn be stored in the ePa. The vital data together with the analysis can then be provided to the physician for evaluation, allowing him or her to adjust treatment, medication, and vital signs prescriptions as needed based on a sound database.
Further implementation options for this concept will be discussed, and evaluated on several use cases. The first use case is the general monitoring of vital signs in an example project, the second is the monitoring of heart failure, which is already part of standard care in Germany. Finally, the management of diabetes and hypertension is considered and applied to the concept of this book.
Overall, the new digital form of care presented in this book can make a valuable contribution to future medical care. In rural regions, it is possible to compensate for the lack of care by avoiding unnecessary visits to the physician without compromising the quality of care. Especially in prevention, there is great potential through the monitoring of personal vital signs in combination with an AI-based evaluation, as this makes it possible to detect impending diseases in their early stages and to intervene in time.