Intended for healthcare professionals

Where Are We Going

Distance technologies for patient monitoring

BMJ 1999; 319 doi: (Published 13 November 1999) Cite this as: BMJ 1999;319:1309
  1. E Andrew Balas, Weil distinguished professor of health pol (,
  2. lias Iakovidis, scientific officerb
  1. Center for Health Care Quality, University of Missouri, Columbia, MO 65211, USA
  2. Health Telematics Unit, European Commission, Brussels, B-1049, Belgium
  1. Correspondence to: E A Balas

    Medical technology once used exclusively in hospitals and general practices is now available for use in the home. A growing selection of innovative electronic monitoring devices is available, but meaningful communication and decision supports are also needed for both patients and clinicians. Several randomised clinical trials of home distance monitoring of glucose concentrations by computer found improved outcomes in diabetes care. Likewise, trials of home distance monitoring of blood pressure show enhanced efficiency. Failure to improve outcomes of high risk pregnancies through home distance monitoring illustrates the difficulties in certain clinical applications. Overall, electronic monitoring at home promises cost effective health services, more active involvement of patients in their own care, and a new sense of realism in making a diagnosis.

    Summary points

    Emerging home monitoring technologies can transform episode driven health services into a relationship based continuum of care

    A growing array of home monitoring devices is commercially available and becoming increasingly affordable.

    Distance monitoring has been shown to improve the clinical outcome of diabetes care.

    Home monitoring of pregnant women illustrates the challenge of improving health and also the need for economic consideration when outcomes are equal.

    Nocturnal haemodialysis, home sleep analysis, and measurement of self care behavioursare among the innovative applications of electronic monitoring.

    The anticipated information surge from patients' homes calls for computerised data processing and active decision support.

    Further randomised clinical trials of distance technologies could produce the scientific evidence regarding safety and efficacy in various areas of care.

    Distance technologies

    With access to home monitoring devices, computers, and communication networks, patients can become more active in their own health care This review lists available technologies for home distance monitoring, assesses its clinical value, and identifies criteria for its appropriate use. Some of the articles included in this review were already in place as part of the Columbia registry—a …

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