(187) Will Patients engage with Digiatl Technologies as part of Routine Healthcare?

Background: Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) are new care delivery options by which patients can provide data to their provider via a biosensor device and/or smartphone app in an insurance reimbursable fashion.

Objectives: Assess patients’ willingness to engage in RPM/RTM and persistence with the program over time.

Methods: Using data from 9/2020 - 10/2023, we examined characteristics of patients who enrolled in a national RPM/RTM program as part of routine care, stratified by medical specialty. Time on the program began in the first month after patients enrolled and contributed data and continued until they voluntarily withdrew from the program, were lost to follow up (i.e., became inactive) or were censored. Kaplan-Meier curves described persistence over time, stratified by medical specialty. Cox proportional hazards models evaluated the time to discontinuation by medical specialty referent to rheumatology, adjusting for age and sex.

Results: A total of 4,671 patients were enrolled into RPM/RTM. The mean age was approximately 70 for all cohort specialties except endocrinology and rheumatology. Persistence with RPM/RTM significantly differed by specialty. Approximately 70 - 80% of patients being monitored for musculoskeletal conditions (orthopedics, rheumatology) were adherent at 180 days. Referent to patients being monitored for rheumatology conditions, the age-sex adjusted hazard ratios for non-persistence with RPM/RTM was more common for endocrinology conditions (which consisted mostly of diabetic patients), not significantly different for orthopedic patients, and lower for other specialties. Older individuals were less likely to be non-persistent with RPM/RTM (adjusted hazard ratio 0.95, 95% CI [0.93, 0.98] per 5-year increase.

Conclusions: At least through 6 months, most patients are persistent with digital health care delivery such as remote physiologic and remote therapeutic monitoring (RPM/RTM). New copay requirements that began in May 2023 (at the end of the COVID-19 Public Health Emergency) for some patients (e.g., commercially insured) likely contributed to some non-persistence. Strategies to optimize patient engagement with such programs are important to maximize the health benefits of these new digital healthcare delivery mechanisms.