Remote monitoring presents a unique opportunity for doctors to get a more realistic picture of their patient’s lives outside the waiting room. For patients living with chronic disease, this should mean a lower management burden and better outcomes.
But a new study out of France has revealed that, when put into use in the real world with real diabetic patients, the effects of remote monitoring can be far more complex.
The researchers used a series of vignette-based online surveys to find out how people living with diabetes perceived different remote monitoring modalities. In total, 1,010 adults were asked to fill out the surveys, with about half living with type 1, less than half with type 2, and the rest living with some other form of diabetes.
The researchers found that how well each remote monitoring modality was received varied heavily depending on what exactly was being monitored and for how long.
When Remote Monitoring Becomes Intrusive
The subjects of the study were asked to rate remote monitoring applications based on a number of hypothetical modalities.
There were 36 vignettes in total, each combining different modalities from three separate categories:
- Monitoring types-
- Activity and glucose monitoring
- Activity, glucose, and occasional food monitoring
- Activity, glucose, and regular food monitoring
- Monitoring duration and feedback-
- One week of monitoring before specific consultations with feedback at that consultation
- One week of monitoring before all consultations with feedback at each consultation
- Permanent monitoring with real-time feedback by one’s physician
- Permanent monitoring with real-time feedback by another caregiver
- Permanent monitoring with real-time treatment feedback by artificial intelligence
- Permanent monitoring with real-time treatment and lifestyle feedback by artificial intelligence
- Data handling-
- By the public sector
- By the private sector
Overall, subjects considered food monitoring and activity monitoring to both be intrusive. Not surprisingly, continuous monitoring with real-time feedback by their physician got high marks for intrusiveness. And private-sector data handling was considered more intrusive than public.
The least intrusive modality, according to the subjects, was glucose monitoring for a week before a consultation with feedback given only at the consultation and data handled by the public sector.
Finding the Balance
The authors of the study believe their results will only become more important as healthcare and remote monitoring move deeper into the private sphere.
“Our findings imply that remote digital monitoring not simply add or subtract burdens but rather transforms them. As health care enters the private sphere, social aspects of the burdens that have been identified in the literature may become more pronounced.”
For those in the business of developing diabetes and remote monitoring technology, their work highlights the need for balance.
Remote monitoring can provide doctors with valuable data to create personalized treatment plans for each of their patients living with diabetes. The more often monitoring is done and the more biomarkers and behaviors that are monitored, the more data doctors have to work with.
But this must be balanced with the perceptions of the patient.
If the use of remote monitoring technology feels intrusive, then the patient will be more reluctant to use it. While this tech is engineered to reduce management burden, the effects of these “transformed burdens” may ultimately nullify the benefits.
The researchers concluded their article by highlighting the importance of designing tech that is customizable based on each patient’s needs and reservations.
“[A] minimally disruptive remote digital monitoring design could help reduce intrusiveness, and shared decision-making could help patients identify the remote digital monitoring that best aligns with their lifestyle and values.”