National Patterns of Remote Patient Monitoring Service Availability at US Hospitals

Background

Digital remote patient monitoring (RPM) enables longitudinal care outside traditional healthcare settings, especially in the vulnerable period after hospitalizations, with broad coverage of the service by payers. We sought to evaluate patterns of RPM service availability at US hospitals and the characteristics of hospitals and the communities they serve that are associated with the availability of these services.

Methods

We used contemporary national data from the American Hospital Association (AHA) Annual Survey to ascertain US hospitals offering RPM services for post-discharge or chronic care. We linked hospitals with their census-based county-level data to define the characteristics of the communities they serve and examined the association of these characteristics with RPM availability. We also conducted an exploratory analysis quantifying the number of patients with key cardiovascular conditions of heart failure (HF) and acute myocardial infarction (AMI) receiving care at hospitals providing RPM services.

Results

The study included 5,644 hospitals. Over five years of study, there was a 40.3% increase in the number of hospitals offering RPM services, rising from 1,364 (33.0%) hospitals in 2018 to 1,797 (46.3%) in 2022. However, the availability of RPM services varied across different hospital groups, with smaller, non-teaching, rural, and hospitals serving low-income communities, particularly in the South, being less likely to offer RPM. Hospitals with more than 300 beds had 3.7-fold odds of offering RPM compared with those with less than 100 beds (aOR 3.71, 95% CI 2.90-4.74). Non-teaching hospitals had a 70% lower likelihood of RPM availability (aOR 0.29, 95% CI 0.19–0.44), and rural hospitals had 50% lower odds compared with urban hospitals (aOR 0.49, 95% CI 0.32-0.77).

Conclusions

In this national study of US hospitals, there has been a large increase in the availability of RPM services but with large variation among hospitals, with lower availability in hospitals serving low-income and rural communities.

What is Known

• Remote patient monitoring (RPM) allows longitudinal care outside traditional healthcare settings through digital technologies and is increasingly reimbursed by payers.

• RPM services have been shown to support care quality and improve access to care and are now endorsed by international clinical guidelines as a core component of cardiovascular disease management.

• RPM utilization in the United States has grown in recent years, driven in part by the introduction of new billing codes and policy reforms.

What the Study Adds

• This is the first national hospital-level analysis to assess the availability of RPM services and identify hospital and community characteristics associated with their adoption.

• RPM availability has grown significantly, but uptake remains lower among smaller, rural, non-teaching hospitals and those serving disadvantaged populations.

• Despite overall increase in RPM availability, the gap observed between urban and rural hospitals persisted over time, indicating that growth in adoption did not translate into a narrowing of geographic disparities in access.