Remote monitoring and telemedicine in general are providing opportunities for patients with chronic illnesses to spend more time in their homes and for doctors to have access to up-to-date information regarding patient health without seeing them in their offices or hospitals.

Naturally, this means that there are benefits for both the patient and healthcare provider as nurses who are trained to interpret the information from these se technological developments can offer sound advice based on a patients current condition at any given moment, and can see patterns that emerge as a result of living in the home setting where care and lifestyle choices are not dictated by the hospital staff or supervising physician. “Outcomes of these disease management systems may include decreased numbers of hospitalizations, decreased medical costs, and increased patient satisfaction and health” (Friedman, 2004, p. 380). Remote monitoring offers a view of the future where fewer visits for routine examinations will occur, thus drastically reducing healthcare costs. With these positive aspects of the technology in mind, however, there are a few questions regarding the lack of face-to-face communication with a nurse or practitioner, privacy and data security issues, and some cost considerations.

History of the Technology

Remote monitoring itself is not a new concept although generally, before the development of the communications and related technological infrastructure, this monitoring required far more effort on the part of the patient, which led to questionable results and furthermore, a still-present need for patients with chronic conditions to attend regular doctor visits for routine gathering of basic data and statistics, including heart rate, blood pressure, temperature, just to name a few. In addition to less technological aspects of patient monitoring, there are technological instruments used in the home, especially for those with diabetes or heart conditions, although these are subject to the same lack of reliability even older methods were. “Today, patients with chronic illnesses typically monitor their condition at home through the use of simple medical devices such as a glucometer or blood pressure cuff. Diabetic patients routinely test their blood sugar levels and often record them in a patient diary, which helps clinicians monitor the patient, but frequently is too incomplete or illegible for effective use” (Blount et al,, 2007, p. 95). In essence, this technology has continued along the same continuum of the rest of society—moving from pen and paper to electronic communication.

Technical Properties

Blount et al. (2007) defines remote monitoring most effectives, stating it “collects disease-specific metrics from biomedical devices used by patients in their homes or other settings outside of a clinical facility and then transmits them to a remote server for storage and later examination by healthcare professionals” (p. 94). The actual properties of remote monitoring technology vary by condition with those having chronic heart conditions using EEGs and other heart-monitors using mobile devices rather than having to attend the clinician’s office to receive such checkups. More generally speaking, these technologies can take all common vital signs and send signals that can be directed to either be viewed immediately or stored for future use. Servers are often housed at the clinician’s offices or the hospital itself, although there is a greater shift in out-housing these servers to more secure, dedicated collocation facilities that specialize in the storage of sensitive data.
The most practical and all-purpose device for remote monitoring of patients is already in use by some hospitals although is still in a beta testing phase. What this technology does is “allows the transmission of vital bio signals (3-12, lead ECG, SP02, NIMP, IMP, and Temperature) and still images of the patient from the incident place to the base unit” (Ali et al, 2005, p. 525 ). One of the more specific uses for remote monitoring is in the area of cardiac monitoring. There are currently mobile electrocardiographs that permit instant communication between the patient’s state and his or her healthcare team, which makes expensive and frequent trips to the cardiologist less necessary at best, and at worst, less frequently.
Many newly-developed technologies that are based on blends between existing medical monitoring equipment, innovative new concepts in electrical engineering, and communications technologies are currently being tested. Shandle (2008) discusses the arrival of the currently tested “wireless EEG monitor designed by the Inter-University Microelectronics Center (IMEC) that integrates electrodes, a biochip sensor, MCU and radio into a package about the size of a very thin wristwatch” (p. 25). Furthermore, when combined with the secure and rapid communications power of Bluetooth technology, for instance, these are not only viable replacements to in-hospital monitoring, but offer excellent technology that does not require high amounts of power or battery use.


Just as in the case with any new technology, there are significant issues regarding the reliability, which could have an enormous impact on the overall safety. There are a number of aspects to consider, the most important of which is what occurs in the case of ceased communication networks, corrupted data, or the inability for the patient to effectively use the equipment. With any variations in any of those three elements related to reliability, the entire concept of remote monitoring is useless. If the data cannot be transmitted or has frequent (or any ill-timed) interruptions, this could literally be a case of life or death, especially in cardiac monitoring that sends data in real-time. While backups and fail-safes, including multiple power sources in the case of an outage or backup communications technology through other carriers are obvious protectors, there is no guarantee that data will not be halted or interrupted at any point, for any amount of time. Furthermore, patients in rural areas (who are among those most benefitted by remote monitoring technology) may not have the same reliable network connectivity that patients in more populated areas have, thus might suffer the disadvantage of having constantly interrupted communication that is unreliable or worse, non-existent. While it is fair to assume that a number of these reliability issues will develop in tandem with the rapid developments in communications technology, it is worth suggesting that there are large reliability gaps that must be addressed and fully tested for solutions before remote monitoring gains widespread use.