Technology that allows for remote monitoring of patients could be a cost-effective way to provide care, especially now that adults are living longer with chronic conditions. In a new randomized controlled trial, researchers evaluated a population of elderly adults with multiple health problems to see how telemonitoring affected the number of hospitalizations and ED visits, in comparison with standard medical care.

All study patients were older than 60 years and considered to be at high risk for repeated hospitalizations. In the intervention arm, a telemonitoring system with the capacity for videoconferencing and measuring physical parameters, such as blood pressure and pulse oximetry, was set up in the home of each patient. The data were uploaded to a Web site that was monitored each day by health care professionals. If a health issue was detected, a nurse spoke with the patient and contacted a physician if treatment was required. Patients in the control arm had their standard resources for medical care, including office visits, nurse telephone consults, and the ED. The study's main outcomes were the combined number of hospitalizations and ED visits in the first year after study entry in each group of patients.

A total of 205 patients were enrolled in the study; 102 were randomized to receive telemonitoring and 103 received standard care. Within the telemonitoring group, 63.7% had hospitalizations or ED visits, compared with 57.3% in the standard care group, although that difference wasn't statistically significant. When analyzing the secondary outcomes of hospitalizations and ED visits separately, there were still no significant differences. The number of patient deaths, however, was higher in the telemonitoring group (14.7%) than in the standard-care group (3.9%).-AK

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