Implementing Store-and-Forward Telehealth in a Remote Patient Monitoring-Home Telehealth Program

Abstract

Background: Store-and-forward telehealth (SFT) is the asynchronous sharing of photo images or short video clips from patients to providers, with patients using their own digital devices. 

Objective: We aimed to enhance patient assessment and increase the use of SFT among providers within a remote patient monitoring-home telehealth (RPM-HT) program. 

Methods: The design for this pilot project was descriptive. It was a 3-month pilot project conducted within a local RPM-HT program that provides nursing care to patients with chronic health conditions in a large regional healthcare facility in the Southeastern United States. We conducted the pilot using the Plan-Do-Study-Act process improvement framework. 

Twenty registered nurse (RN) care coordinators were asked to identify two clinical opportunities for using SFT. Patients uploaded the images or videos via the virtual care management system. The goal was for the patient to upload 40 to 50 high-quality clinically significant video clips or images and use the image for a clinical encounter. An RN care coordinator survey solicited insight about the provider experience. 

Results: Of the 81 patients who agreed to submit an image or a video, 30% submitted at least one image or video, for a total of 42 useable images. The RN care coordinators were generally positive about the use of SFT in RPM-HT, citing better opportunities for physical assessment and improved patient access to care. 

Discussion: Integrating the use of SFT into RPM-HT provides opportunities for improved care coordination and enhanced clinical assessment, plus a new opportunity for patient access. Wider implementation of SFT into similar programs may improve patient outcomes. The outcome was the creation of a user-friendly process for integrating SFT into the RPM-HT program. Challenges included patient and provider participation and patient use of technology.