The role of remote patient monitoring in chronic disease management among underserved U.S. populations: A scoping review

The underserved populations in the United States, which are racial and ethnic minorities, low-income individuals, residents of rural regions, have disproportions of chronic diseases. Remote patient monitoring (RPM) has become an effective approach, capable of enhancing the management of the chronic disease and eliminating health disparities, but the strategy of its functioning and its use in underserved groups are not fully described.
The review is a synthesis of the existing research on RPM interventions to manage chronic diseases in underserved populations in the United States, the study characteristics, clinical outcomes, implementation factors, as well as obstacles to adopt the intervention. We  identified 207 distinct articles of which 60 articles qualify to be included in the detailed synthesis. Most of them were centered on hypertension management (n=35), diabetes management (n=28) and heart failure management (n=22). Studies predominantly involved African American and Hispanic/Latino populations, patients in Federally Qualified Health Centers (FQHCs), rural communities, and low-income individuals. The interventions of RPM showed good clinical outcomes such as reduction in blood pressure (5.8-15.1 mmHg systolic), HbA1c (0.25-1.5%) and hospitalizations (18-27%). The results of implementation were both feasible and acceptable with the engagement rates of the patients reaching 70-92%.  
RPM interventions demonstrate great potential to better chronic disease management in underserved U.S. populations, and outcomes are clinically effective in a wide range of diseases. Nonetheless, the implementation needs to be successful, which means dealing with the problem of digital divide, related to cultural competence, and combining RPM with an integrated care management approach.