Remote patient monitoring (RPM) is a technology to enable monitoring of patients outside of conventional clinical settings (e.g. in the home), which may increase access to care and decrease healthcare delivery costs. Examples include sensors in patients, sensors in or on things (internet of things) or remote measuring devices using telecommunications technologies like smart bathroom scales to measure the weight of patients with congestive heart failure.

PROMIS, on the other hand , refers to patient reported outcomes measurement information systems and typically requires patients to manually input data on a desktop or mobile device. (ePRO).

One complements the other. In general, PRMs measure signs or response to treatment, physiological parameters (heart rate) or analytes (blood glucose), while PROMIS measures symptoms or symptom scores like pain, anxiety, or difficulty breathing. Increasingly, we are seeing technologies that disintermediate the patient reporting requirement and , instead, automatically measure and report data to central repositories or electronic medical records.

But, all this data, data everywhere creates big challenges requiring big solutions.

That said, as part of the 4th industrial revolution, we will see increasing development of tools that integrate and make sense out of materials (graphene and nanomaterials), machines (3-D printers, robots), medicine and computer memory, speed, storage and intelligence.

For example, suppose you are a patient with some form of inflammatory bowel disease, like Crohn’s disease or ulcerative colitis, and you are taking a very expensive drug to treat it. How do you and your doctor know that it is still working? You will swallow a remote patient monitor to measure bowel structure and function and you will use your iPhone to report symptoms that will determine whether you should continue to take the medicine or change to something else.

In coming years, patient-reported measures are expected to play a more prominent role in assessing performance and determining the comparative effectiveness of different treatments, in part because of a growing emphasis on patient-centered care and value-based payment approaches.

Now, Amedzon wants you to use Alexa to track your health.

The anatomy and physiology of remote sensing creates big possibilities to intervene and innovate at multiple points of the system with applications in basic, applied and translational research, development, commercialization, dissemination and implementation. Balancing high tech with high touch while improving doctor and patient engagement to improve quality while reducing costs is the PROMIS.