New Medical Economics held a new workgroup meeting and debate focused on a crucial and current issue: ‘The future of healthcare: telemonitoring, telemedicine and new healthcare models’ This online event brought together professionals from the sector and was sponsored by Masimo, an international benchmark in clinical monitoring technology.
The event was moderated by José María Martínez García, president of New Medical Economics. The round table was chaired by Pau Imaz Boada, senior strategic manager of Hospital Automation and Remote Patient Monitoring (RPM) at Masimo.
The meeting was attended by top-level professionals, such as Glòria Bonet Papell, head of the Home Hospitalisation Unit (HAD) at the Hospital Universitari Germans Trias i Pujol (Badalona) and Communication spokesperson of the Spanish Society of Home Hospitalisation (SEHAD); Iván Valero López, coordinator of the Home Hospitalisation Unit at the Hospital Universitario del Henares (Madrid); Óscar Díaz-Cambronero, coordinator of the Perioperative Medicine Unit of the Hospital Universitari i Politècnic La Fe (Valencia); and Ana María Angulo Chacón, head of the Home Hospitalisation Unit of the Paediatric Department of the Hospital General Universitario Gregorio Marañón (Madrid).
A necessary transformation, driven by technology and centred on the patient
The session was opened by José María Martínez García, who highlighted the transformative role of digitalisation, artificial intelligence and new healthcare models. ‘Telemonitoring, telemedicine and value-based care are not futuristic: they are pillars of care if we want to guarantee sustainability, quality and equity,’ he said.
Martínez also emphasised the need to adapt regulatory frameworks and professional training to this new reality. ‘Healthcare is migrating from reactive to predictive, and from the hospital to the home. It is a major shift that we must lead through evidence and coordination’.
The event began with a presentation by Pau Imaz Boada, who explained how the Masimo SafetyNet solution enables patient monitoring from emergency to home discharge through an app connected to reliable and interoperable sensors.
‘The key is not only technology itself, but also working together with healthcare professionals to integrate this tool into real clinical processes,’ he pointed out. He also indicated that with this solution ‘we have managed to reduce admissions to the ICU, reduce adverse events and increase adherence to care programmes’.
Experiences in home hospitalisation
Glòria Bonet Papell, head of the Home Hospitalisation Unit at the Hospital Universitari Germans Trias i Pujol (Badalona), explained how her Service has evolved in recent years towards a fully integrated, digitalised and multi-specialty model, after over two decades of experience. ‘Regarding telemedicine and remote biometrics,’ she emphasised that ‘ours is not a pilot test, it is a way of working’, stressing that hospitalisation at home is a real, safe and effective alternative, and that new technologies will help bring this type of admission even more in line with conventional hospitalisation.
Bonet explained that her Unit serves a reference population of more than 400,000 inhabitants and that, thanks to a firm institutional commitment to digital transformation, they have managed to remotely monitor more than 40% of their patients through a mixed system that combines connected devices (watch, blood pressure monitor, scale, thermometer) and an interoperable institutional app developed together with the ICS digital transformation department.
Concerning the app (eSalut), Gloria Bonet explained that they have adapted it to the needs of the HAD, ‘it gives us information on how the patient is in the morning and afternoon, and we have built different verticals according to prevalent pathology (COPD, acute infections, postoperative surgery, geriatric care, etc.). Each one incorporates adapted interactive questionnaires and health education content, including videos on self-administration or specific care. Moreover, with the SESHAT remote biometry programme, funded by CatSalut, we have automated monitoring of basic vital signs’.
From left to right: Óscar Díaz-Cambronero, Glòria Bonet Papell, Pau Imaz Boada, José María Martínez García, Iván Valero López, and Ana María Angulo Chacón.
Iván Valero López, coordinator of the Home Hospitalisation Unit at the Hospital Universitario del Henares (Madrid), addressed the key role of continuous telemonitoring at home as a tool for reducing clinical uncertainty, increasing the safety of care processes and optimising system resources.
With an eminently practical and clinical approach, Valero explained how his unit, after just three years of operation, has managed to incorporate continuous monitoring technology in a structured way in two major lines of care: patients with acute or chronic decompensated heart failure and patients with complex infectious diseases that require close surveillance at home, such as pneumonia, bacteraemia or endocarditis.
‘With objective data and 24/7 monitoring, we provide safer discharges and avoid unnecessary visits,’ he said. This monitoring is done through non-invasive sensors that collect real-time variables such as heart rate, respiratory rate, oxygen saturation and temperature. The data are integrated into a digital platform that emulates traditional nursing records, making it easy for the clinical team to interpret them.
‘The patient’s subjective perception is important, but often insufficient to detect real decompensation,’ Valero said. As an example, he shared cases in which bradycardias of up to 35 beats per minute were detected during the night, which were not referred by the patient the next day because they did not notice symptoms. ‘Technology complements, not replaces, our clinical intervention. It allows us to see what the patient is not saying and to anticipate what might happen,’ he pointed out.
In addition to physiological data, the unit uses personalised digital questionnaires that the patient answers through the mobile app. Their answers generate automatic alerts when clinical deterioration or deviations from the expected evolution are detected. This system has made it possible, for example, to prioritise visits, adjust treatments in time and make decisions with greater confidence, even at night, when the service is covered by other healthcare services such as SUMMA.
Valero also highlighted the added value perceived by patients and carers themselves: ‘They are at home, with their routines, but they feel accompanied by the hospital at all times’. Continuity of care is reinforced by daily calls, on-site monitoring and retrospective analysis of the graphs generated, which has contributed to greater user satisfaction and better functional recovery rates.
Finally, he defended the need to continue moving towards longitudinal and predictive monitoring for chronic patients, integrating these systems across care levels and with Primary Care. ‘If we are able to anticipate a decompensation before it appears, we will be truly transforming healthcare,’ he concluded.
Ana María Angulo Chacón, head of the Home Hospitalisation Unit of the Paediatric Department of the Hospital General Universitario Gregorio Marañón (Madrid), shared at the meeting the evolution and results of one of the few consolidated experiences of paediatric home hospitalisation in Spain. The unit, launched at the end of 2023 within the Maternal and Child Area of the hospital, has treated more than 350 children in its first year of operation, thus avoiding nearly 1,800 hospital stays.
‘Our patients are at home, but with the same high standards of care as in the ward,’ said Angulo, stressing that quality and safety are not negotiated by the fact that they are at home. The unit is part of the global programme of home hospitalisation at the Gregorio Marañón, which also includes the adult, child-youth mental health and haematology units. As for paediatrics, the team is made up of paediatricians and highly specialised nurses, and is supported by all the hospital’s surgical and medical specialties.
Most patients admitted in this modality come from Oncohematology (43 %) and Paediatric Internal Medicine (37 %), followed by Infectious Diseases and Intensive Care. The most frequent pathologies include invasive fungal infections, bacteraemia, bronchopneumonia, bronchospasm and post-ICU follow-up in newborns or complex chronic patients. ‘It is not about early discharge, but about continuing at home an admission that is a hospital admission, with all its clinical and safety standards,’ the doctor pointed out.
One of the keys to the model has been the implementation of the Paediatric Early Warning System (SAPI) at home, a common tool on the hospital ward that allows early detection of signs of clinical deterioration through the standardised collection of physiological and observational parameters. Families record variables such as respiratory and heart rate, level of consciousness, oxygen use and perception of respiratory distress on a structured sheet. ‘SAPI at home allows us to react quickly if something changes. If the threshold is exceeded, it triggers an immediate medical assessment,’ Angulo explained.
The other great strength of the programme is its strict health education protocol for caregivers and parents, which ensures the correct administration of medication, the use of devices (such as subcutaneous infusion pumps) and clinical monitoring of the child. ‘The success of the model depends largely on the commitment and training of families. That is why we dedicate time, adapted materials and continuous accompaniment,’ he said.
Experience in perioperative medicine
Óscar Díaz-Cambronero, coordinator of the Perioperative Medicine Unit at the Hospital Universitari i Politècnic La Fe (Valencia), explained how his hospital has managed to integrate telemonitoring through the whole surgical process, from the pre-operative consultation to the patient’s functional recovery after discharge. His presentation highlighted the importance of designing innovative care circuits based on individual data and proactive decisions, especially in the context of major oncological surgery.
‘Surgical complications are the third leading cause of death in the world. If we are not proactive, we are too late,’ he warned, calling for a cultural change in perioperative medicine to anticipate adverse events instead of simply reacting to them. Accordingly, La Fe has developed a comprehensive preoperative home rehabilitation programme in which the patient is monitored weeks before surgery with wearable devices that continuously record heart rate, temperature, oxygen saturation levels and other relevant biometric parameters.
The innovative aspect of this approach lies not only in the use of technology, but also in the methodology based on the personalised baseline profile of each patient. ‘We assess deviations from the individual baseline, not population guidelines. If a patient deviates more than 20 % from their previous average, an alert is generated. We are talking about truly personalised medicine,’ he explained.
This model allows for early identification of alterations in post-surgical evolution, optimising clinical decisions in real time and reducing the need for readmissions or prolonged stays. Likewise, the programme includes close collaboration with the Home Hospitalisation Unit, which is responsible for face-to-face and telephone follow-up during the first days after discharge, with access to all monitored variables integrated into the hospital’s electronic medical history.
Finally, Díaz-Cambronero pointed out that this model not only improves clinical outcomes, but also the experience of patients, who feel more accompanied and empowered. ‘The patient becomes an active protagonist in their process, and we become guides who accompany them with information, criteria and valuable tools,’ he concluded.
More integration, interoperability and role redefinition
The panel addressed key issues such as alert fatigue, integration between care levels and the role of caregivers as key players in the process. All participants agreed that ‘technology must be at the service of closer, more humane and more sustainable care’.
Díaz-Cambronero concluded: ‘This is not about just another device, this is about integrating processes in a structured way. Perioperative medicine must be based on data, and that can only be achieved through continuous monitoring’.
Towards connected, personalised and safe care
This workgroup made it clear that the transformation of the healthcare model involves extending hospitalisation at home as a real and effective option; monitoring with continuity and reliability from emergency to home discharge; personalising care with objective data and individualised clinical follow-up; creating multidisciplinary teams with new profiles, such as digital nursing; and committing to interoperability and the integration of clinical data between levels.
José María Martínez García closed the event with a final thought: ‘The combination of clinical talent, technology and commitment to care can radically improve the way we care. The key is to connect knowledge, processes and tools with a focus on the patient’.
