Remote Patient Monitoring Shows Potential for Managing Complex Chronic Disease

Digital remote patient monitoring (RPM) could play a pivotal role not only in improving hypertension control for high-risk patients but also in helping health systems navigate the growing financial pressures tied to chronic disease management, according to a new analysis from UC San Diego Health.¹ The study’s findings come as payers increasingly reimburse RPM services and as health care organizations search for scalable ways to reduce avoidable hospitalizations and long-term cardiovascular costs.

The findings, detailed in JMIR Cardio, align with earlier telehealth and RPM research demonstrating sizable improvements in blood pressure control and medication adherence.^2,3 However, this study is one of the first to examine real-world outcomes for a large cohort of multimorbid patients within an EHR-integrated care model. The authors argue that such programs are well-positioned to scale as reimbursement structures evolve, particularly as evidence accumulates showing cost savings alongside clinical gains.¹

“Concrete clinical findings such as these call for increased uptake of RPM,” wrote researchers, adding, “We expect the financial benefits of RPM to increase as more health centers adopt similar programs and benefit from economies of scale and accrued knowledge about best practices for establishing such programs, as well as managing patient support procedures from a technical and clinical perspective.

More than 2,200 adults in UC San Diego’s Digital Health Program used Bluetooth-enabled blood pressure cuffs connected to the EHR, with a centralized team managing treatment based on real-time data. By comparing SBP before and after enrollment, researchers were able to measure the added health benefit of this RPM model beyond usual care.

Patients with hypertension alone saw an average SBP reduction of nearly 10 mm Hg (9.76; SE, 0.81; P < .001), while those managing 1 or 2 additional chronic diseases still achieved reductions of 6.6 mm Hg (P < .001).

Because not all referred patients consistently used the monitoring technology, the researchers separately examined outcomes among active participants, defined as those who submitted at least one home reading. When scaled to this group, the SBP reductions were even greater: 16.83 mm Hg for hypertension alone, 13.22 mm Hg for patients with one additional chronic condition, and 16.01 mm Hg for patients managing all three. These results indicate that regular engagement with the digital tools can amplify clinical benefit.

“Although the MCC groups had a lower baseline SBP—potentially indicating more intensive prior management—this study still substantiates and extends the findings of previous prospective quality improvement programs and randomized controlled trials focused on patients with hypertension alongside hyperlipidemia, diabetes, or heart disease,” wrote the researchers.

The program’s implementation also underscored the importance of addressing digital literacy and equity concerns. Many RPM initiatives struggle with adoption among older adults or patients from disadvantaged communities. UC San Diego sought to mitigate these barriers through multilingual tools, personalized outreach, and even home visits for device setup when needed. The study noted that lower participation rates among patients with MCC may reflect the heavier self-management burden they already face, emphasizing the need for more passive, low-friction monitoring technologies in future program expansions.

The authors acknowledge limitations of their study, including possible selection bias and the challenge of sustaining long-term participation. Still, as reimbursement frameworks mature, the study provides a timely real-world example of how technology-enabled hypertension management can fit into the broader financial architecture of chronic disease care.

References

1. Graham Rr, Fadlon I, Agnihotri P, Longhurst CA, Tai-Seale M. Outcomes of team-based digital monitoring of patients with multiple chronic conditions: semiparametric event study. JMIR Cardio. Published online December 8, 2025. doi:10.2196/75170

2. Blood AJ, Cannon CP, Gordon WJ, et al. Results of a remotely delivered hypertension and lipid program in more than 10,000 patients across a diverse health care network. JAMA Cardiol. 2023;8;(1):12-21. doi:10.1001/jamacardio.2022.4018

3. Remote monitoring and pharmacist helped improve hard-to-control blood pressure. American Heart Association. Published September 5, 2024. Accessed December 22, 2025. https://newsroom.heart.org/news/remote-monitoring-and-pharmacist-helped-improve-hard-to-control-blood-pressure