Remote control: The growth of home monitoring

Insurers increasingly are using home systems to track their members' health. But with this emphasis on cost control, some fear the physician is being bypassed.

By Tyler Chin, AMNews staff. Nov. 18, 2002.

The concept of home monitoring for patients with chronic conditions has been around for several years, but insurers now are aggressively adopting the practice to stem soaring medical costs.

Patients with chronic conditions account for a disproportionate share of health care costs. So if insurers can lower those costs, they will be able to retain more of the premium dollars that employers and members pay, and Wall Street also will reward them with higher stock prices.

Employers are not specifically asking health plans to do home monitoring, but they do ask HMOs about possible cost savings through disease management, of which remote monitoring is a tool, said Kathy Cartelli, director of health management at PacifiCare Health Systems Inc., Santa Ana, Calif., which, since 2000, has monitored patients with congestive heart failure.

Despite many physicians' mistrust of insurers, some applaud this remote patient monitoring. But physicians are concerned they would not be treated as equal partners with the health plan and the disease management company, and that nurses handling the monitoring for insurers could unintentionally circumvent the treatment plan.

Related AMA policy, which speaks generally about disease management, "strongly encourages health insurance plans and managed care organizations that provide disease management to involve the patient's current primary or principal care physician in the disease management process as much as possible, and to minimize arrangements that may impair the continuity of a patient's care across different settings." [...]