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Remote monitoring technology helps seniors breathe better at home

Chronic Obstructive Pulmonary Disease (COPD) is responsible for the second largest number of inpatient hospitalizations in Canada. Living with chronic illness often means frequent visits to the emergency department and long hospital stays. Until now. 

Equipped with the right technology, care teams can monitor a patient’s condition remotely―making it ideal for managing chronic conditions such as COPD. By identifying decompensation sooner, the care team can intervene early to address or even prevent acute exacerbations. The result is reduced hospital admissions, emergency department visits and more empowered patients. 

Patients are given a tablet along with other tools to measure their vital signs including blood pressure, heart rate, weight and oxygen saturation. This data, along with self-assessment surveys on symptoms and well-being are automatically sent to the patient’s care team. With this solution, developed by Cloud DX, a virtual consultation between clinicians and their patients is also at their fingertips.

According to Cara MacDonald, Senior operations manager at Cloud DX, remote patient monitoring (RPM) solves many issues facing Canadians and the Canadian health care system. “RPM allows patients to stay home longer, reduces hospital visits and reduces length of stay when an admission isn’t avoidable.” 

MacDonald and the Cloud DX support team—which includes registered practical nurses (RPNs) and personal support workers (PSWs)—work closely with patients to establish a comfort-level with technology. 

What she’s learned working on projects such as the Breathe Better Program with Markham Stouffville Hospital (MSH) is this:

Digitally savvy patients are not required

There’s a common misconception that a patient must be a certain age or have a certain experience level with technology to succeed. In her experience, patients are enthusiastic to learn more about their chronic condition and take control of their health. 

“Patients as old as 98 have eagerly participated in COPD RPM programs with outstanding compliance, and incredible outcomes,” shares MacDonald. Embracing the mentality anyone can learn is beneficial to both the health and overall well-being of patients.

Debunking the myth that patient engagement leads to compliance

“We’ve found it’s actually the other way around,” says MacDonald, “where compliance leads to patient engagement.” To encourage this, especially at the initial stage of deployment, the Cloud DX support team frequently connects with patients. They make sure these patients feel comfortable and well-equipped to use the technology in cooperation with their care team’s action plan and resources. “When we speak with patients, it gives us the opportunity to build a meaningful relationship with them and become an extended part of their overall care team,” she says. 

“Taking daily vital sign measurements becomes habit for patients, and they gain a sense of what is ‘normal’ and what is concerning. They become empowered to take better control of their health and self-manage their COPD, MacDonald adds.” Peace of mind extends beyond the patient to their family and other caregivers as well.

“Patients quickly get into the habit of taking their readings daily and appreciate the peace of mind that comes along with knowing how to interpret this information. Patients often share that knowing that someone will call them if they need help is very reassuring”

- Cara MacDonald, Senior operations manager, Cloud DX

Enter the champion

According to MacDonald, enthusiastic allies are an integral part of a successful deployment. “Having an internal champion within each partner group is vital,” she stresses, “especially in a clinic or hospital.” MacDonald credits respiratory therapist and clinical project lead Katrina Engel for the success of the deployment at MSH. 

“I place a large part of this triumph directly on Katrina’s shoulders,” enthuses MacDonald. “She was personally invested, and her commitment to her patients and introducing remote patient monitoring for COPD speaks to her amazing abilities. She is the ideal partner and champion.”

“An internal champion within each partnership is vital, especially in a clinic or hospital.” 

- Cara MacDonald, Senior operations manager, Cloud DX

Adaptability leads to better outcomes

Every pilot project comes with a set of protocols in place. MacDonald affirms versatility can move the needle more quickly. “In a traditional or non-pilot project, you have more flexibility,” she says. “Being nimble and adaptable supports better patient outcomes and successful projects.”

Once deployed, RPM programs such as these are a win for everyone involved—patients, caregivers, providers and health care institutions. At scale, the impact on our health care system would be tremendous. This begs the questions: how, and what would it take?


This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule.  Feel passionate about physician-led innovation? Please connect with us at