Feasibility of Remote Physiologic Monitoring (RPM) in Geriatric Psychiatry Clinic Patients

• Published in: The American journal of geriatric psychiatry 2024-04, Vol.32 (4), p.S131-S132
• Main Authors: Greenwald, Blaine, Nikzad, Amir, Scott, Jamie, Haque, Rehana, Mittal, Sukriti, Vengassery, Aninditha, Austria, Bienvenida, Rahaman, Yogita, Mertz, Kathryn, Ronay, Avy
• Format: Article
• Language: English
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1016/j.jagp.2024.01.221

In the context of a pandemic-catalyzed movement to home-based healthcare, remote physiologic monitoring (RPM) is more actively emerging as a key tool, including in older patients. However, to our knowledge, limited information is available regarding RPM use in geriatric psychiatry patients. In concert with the RPM Workgroup of Northwell Health, a quality improvement (QI) initiative was launched to explore RPM feasibility in geriatric psychiatry outpatients. Wearable and non-wearable devices were selected. Geriatric psychiatrists referred appropriate patients from the Geriatric Psychiatry Clinic at Zucker Hillside Hospital in Queens, NY. Explanation/introduction of devices were made to patients, and agreement to participate achieved. The following devices were utilized. The “biobutton’ is a half-dollar sized wearable device that affixes to the chest, and measures heart rate (HR), respiratory rate (RR), sleep and activity. It passively collects data and then intermittently communicates to a nearby relay device which in turn transfers the data to the cloud. An intermediary health technology company then translates the data into a user-friendly dashboard that can be accessed by clinical providers through a portal. Ten patients were recruited for this pilot. The non-wearable devices employed were a blood pressure (BP) cuff and a weight scale with built-in SIM card-based connectivity that enables instant data transmission to a cloud-based clinician dashboard. These devices were demonstrated for patients to ensure familiarity with activation. Both devices were then sent to patients’ homes. Fifteen patients participated. Patients were provided with 24-hour phone support for potential glitches and concerns. Continued participation was based on the integrity of data flow and regular patient follow-ups. At the completion of each program, multi-parameter feasibility/satisfaction surveys (Likert-like 5 point scales; 1 = least favorable, 5 = most favorable) were administered to patients and geriatric psychiatrist providers. Wearable/passive RPM (biobutton): The average scores over all survey questions were respectively 4.7 and 4.0 for patients and providers. Detailed participants’ ratings were: general satisfaction (4.7), satisfaction with the enrollment process (5), satisfaction with device maintenance (4.3), satisfaction with support (5), ease of use (5), interest to continue use (4.2), and recommending to others (4.5). Detailed providers’ ratings were: general satisf