The Remote Patient Monitoring (RPM) system at Mayo Clinic allows doctors to monitor patients' health from a distance. It involves collecting biometric data from patients through mobile devices and transmitting it to medical practitioners. Mayo Clinic developed its RPM system to address issues like rising patient admissions, high emergency room visits, and the need to improve access to specialty care. The system is managed by the Center for Connected Care and involves training for medical staff. Strict security and privacy measures protect patient data collected by the RPM system.

1. 1
Remote Patient Monitoring System at Mayo Clinic
Student Name
University
Course ####:
Course Title
Instructor Name
Due Date

2. 2
Remote Patient Monitoring System at Mayo Clinic
This report details the use of a ground-breaking health information technology (HIT), the
Remote Patient Monitoring (RPM) system. This technology bridges the gap between the patient
and the medical practitioners. In practice, this technological service forms part of telehealth.
Telehealth refers to the administration of medical duties and services to patients remotely.
However, telehealth can involve multiple systems other than the RPM in taking medical services
to patients away from the traditional hospital setting (Hathaliya et al., 2019). Overall, it is an
impressive medical solution because it makes it possible for hospitals in general to save costs,
lower patient queueing while providing patients with comfortable, homely treatment among
other benefits (Annis et al., 2020). The application of RPM at Mayo Clinic will be analyzed in
this project with the main goal being to provide ample information about this modern and
important technological solution.
Organization Information
RPM System at Mayo Clinic
The RPM system is defined by Noah et al. (2018) as a healthcare delivery system. This
system uses the latest advances in information technology in gathering patient data that is outside
of traditional healthcare settings. In doing so, this system enables the doctors and nurses to
monitor the health of the patients from a distance. Through this system as well, prescriptions can
be issued together with pertinent medical advice to the patient. Malasinghe et al. (2019) explain
that the RPM system has helped to move healthcare out of the traditional setting and into the
homes of patients, their places of work, and their everyday lives. Effectively, it helps to bridge
the space that the traditional physical setting of healthcare could not cover. With lives lost due to
the inaccessibility of hospitals in the past, the RPM was designed to shorten the time taken by

3. 3
patients to have their health monitored by professionals and to get advice on how to deal with
medical issues in a timely fashion.
Mayo Clinic is a top clinic in the United States. The Center for Connected Care at the
Clinic is the department that deals with all matters pertaining to telehealth. This department is
located in Rochester, Minnesota, and is focused on the diffusion and resourcing of digital health
solutions (Center for Connected Care, 2019). This program combines advanced technologies
with the Clinic’s highly-rated medical services from its top practitioners.
Type of Medical Solution
The RPM can be classified as a clinical system. It is often used as a bridge of information
between the patients and the doctors/nurses. The doctors get information from the system
regarding a patient’s vitals and other details. The patients get information from the
doctors/nurses regarding their body’s condition and prescriptions on what to do next. While
telehealth is a broad field that encompasses multiple activities, the RPM plays the vital role of
facilitating the collection, sharing, interpretation, and treatment of patients remotely (Vegesna et
al. 2017). As such, it is a system that facilitates the dispensation of clinical duties which is why it
is classified as a clinical HIT system.
Reasons for Development of an RPM System
At Mayo Clinic, the problems that led to the development and adoption of an in-house
RPM system were as follows. On a daily basis, the Clinic is reported by Griggs et al. (2018) to
receive more than a million people from all 50 states and others from a total of 140 countries.
These people are treated in Minnesota, Florida, Arizona, Wisconsin, and Iowa. The Clinic offers
primary care and specialty treatment in Minnesota, Rochester, Florida, Jacksonville, Arizona,
and Phoenix. The Clinic serves millions of people yet its reach is rarely adequate. There are

4. 4
communities that the firm considers left-out. The Clinic established that there was an acute
inadequacy of specialty care information and services in most communities in the US despite
Rochester branches have the requisite resources. As well, this Clinic was being forced to run at
full capacity at all times. The high number of patients that were treated at the institution could at
some point in the future being unsustainable (Hathaliya et al., 2019). Thus, the management of
the firm saw it fit to find a sustainable solution to these problems.
One benefit of adopting the RPM was that it would take specialty resources to people
with specialty care needs, remotely. It would also allow the firm to treat patients from their
homes and workplaces without having them on-site. This helped reduce the queues at the
hospital and lessened the workload for on-site practitioners (Annis et al. 2020). This was how the
RPM system was conceived within the firm and adopted.
Need Determination for RPM System
The needs that lead to the adoption of the RPM at Mayo Clinic were identified by a needs
assessment done on behalf of the organization by Ellsworth et al. (2016). It was established that
Mayo Clinic had been experiencing rising admission numbers each year. It would have led to
extremely high numbers in the future as populations increase. This would force the Clinic to fork
out considerable amounts to construct new branches. Further, the Clinic was found to be
experiencing rises in emergency room visits. Given the costs incurred in emergency rooms and
the sensitive nature of care, the firm welcomed solutions to reducing the number of visits. The
management at Mayo is reported to have been keen on improving patient satisfaction (Mayo
Clinic, 2020). To do so, the Clinic needed a system that can increase the contact between patients
and doctors/nurses with added comfort on the side of the patient. Another need was to cut costs
of care in general. Whenever patients visit the hospital, overhead costs are incurred such as

5. 5
gloves used to examine patients and other similar costs. Lastly, the firm was found to be keen on
improving medication compliance in all its operations. It is often a challenge when a hospital is
attending to millions of patients each year, like in Mayo Clinic’s case.
Fulfilling Needs Identified
Ellsworth et al.'s (2016) report further explained that the application for RPMs in
healthcare settings is up to 88% in the United States. It is because the system addresses the needs
identified earlier. For instance, the RPM system could help reduce admissions by 38%, reduce
emergency room visits by 25%, improve patient satisfaction by 25%, while cutting costs of care
by 17%. As well, it was found that medication compliance could be improved by 13%. Mayo
Clinic managers determined that the RPM’s benefits would help alleviate most of the problems
identified within the needs-assessment program. These improvements were, therefore, found to
be directly related to the challenges faced at Mayo Clinic. They are the reasons why the RPM
was adopted at Mayo Clinic.
Management of the RPM System at Mayo Clinic
As noted earlier, the Center for Connected Care (CCC) is in charge of the RPM system at
Mayo Clinic. It is headed by Tufia Haddad, the medical director of the CCC. In the most recent
global pandemic, the CCC found great use of the RPM. The firm managed to monitor the health
of COVID-19 patients once they were sent home. Through the Mayo Clinic App, were
monitored on a 24-hour basis using their biometric data. The director explained that the data
collected is held in the firm’s data storage facilities. The management of this important data,
therefore, lies in the hands of the IT department. A statement from that department reveals that
all data collected is protected by the encryption technology known as the Secure Sockets Layer
(SSL) (Haddad et al., 2021). The administration of this encryption is done by the Mayo Clinic’s

6. 6
Privacy Officer whose office is at Rochester. The privacy officer is a department head within the
organization’s structure heading the data privacy department. It is commendable that the firm has
a dedicated department to ensuring the privacy of all patients as per existing laws. There are
stringent measures executed as explained on the firm’s site (Mayo Clinic Staff, 2019). This
department handles the information collected through the RPM system on the Mayo Clinic App
with the same stringent security measures.
RPM System Design and Development at Mayo Clinic
Stakeholders Involvement
The major stakeholders at Mayo Clinic are patients, doctors/hospitals, the government,
and payers. Of these stakeholders, the doctors were involved in deciding to adopt the RPM. Top
doctors and nurses in all branches of the firm are reported to have been involved in deciding how
the RPM program would take shape in the firm. The report further states these stakeholders were
asked to continually offer their input regarding the usability of the program and its viability.
Haddad et al.'s (2021) report found that the use of mHealth devices used in RPM monitoring and
telehealth at the firm were designed with substantive input from doctors and nurses of the
institutions plus IT experts consulted by the firm. This shows the reliance of the firm on its
workers in making technological solutions that they will be using. Masterson's (2018) study
established that stakeholder involvement and participation in decision-making in hospital settings
is a major determinant of success. Griggs et al. (2018) echo that premise noting that the adoption
of technology has to involve both the users and the end-users of the technology in decision
making to make it a success. By involving the doctors/nurses, the Clinic achieved the first part of
success in the deployment of the RPM.
User Involvement

7. 7
As alluded to above, the involvement of the end-users of technological adoption in the
medical setting is the second determinant for success. In the case of Mayo Clinic, there is no
evidence showing direct involvement of patients in the design and application of the RPM
system. However, the firm has a feedback button on the Mayo Clinic App. Through it, patients
are allowed to submit their feedback regarding various forms of RPM. One such feedback was a
recent publication by Haddad et al. (2021) the Emergency Medicine Physician, Deepi Goyal who
had COVID-19 and was treated through the Remote Patient Monitoring Program. He stated the
Mayo Clinic App gave him a “tremendous sense of comfort having that program.” The App
management team at the firm is responsible for taking such feedback and acting accordingly.
When negative feedback is sent, the firm notifies the relevant departments for corrective action
to be taken immediately (Mayo Clinic, 2020). To this extent, it can be concluded that the RPM
execution at Mayo Clinic may have lacked an initial patient inclusion when developing the
service but it has an ongoing feedback system that helps to improve the RPM continually.
Training Programs on RPM
The company has a dedicated training wing. This wing is within the human resource
department is meant to offer doctors and nurses information on how to make the best out of the
telehealth facilities provided. In particular, the firm has released a number of videos to doctors
and nurses on YouTube to inform health practitioners on how to execute RPM. This video is
published on the official channel of the clinic voiced over by Tufia Haddad, the director of the
RPM program at CCC (Mayo Clinic, 2020b). Below is a screengrab showing Tufia’s training.
Figure 1: Screengrab of Haddad’s Training RPM

8. 8
Source: Mayo Clinic (2020b)
The RPM program at Mayo Clinic reports on its website that the firm is committed to
continuous improvement. As such, the program updates its devices plus the training programs
that are in-house to relevant doctors and nurses. The process of determining which information is
relevant and needs to be added depending on prevailing medical challenges is done by the Center
for Connected Care. The organization offers education to doctors, nurses, and to patients as well
whenever new information is uncovered and affects any of the three parties (Gannon, 2020).

9. 9
Hence, it is inferable that the Clinic is committed to offering timely and quality training to its
practitioners while keeping patients updated at the same time. It is a well-rounded training
program.
Security issues
The main security issues associated with RPM are data security and protection as well as
possible misuse of said data. As a technological solution that works with user information, the
RPM poses security threats. If the data collected were to fall into the wrong hands, it would
result in colossal privacy issues. It could lead to a number of issues top among them being the
loss of public reputation that Mayo Clinic has built and maintained for many years now. At
Mayo, the firm has established a committed department to privacy protection for all patient data.
This department is headed by a privacy officer, John Signorino, in Rochester, Minnesota (Mayo
Clinic, 2020). The department is fully operational and its main role is to monitor possible data
breaches while maintaining high-security standards for all data.
The second issue regarding the data collected is how it is used. This part falls in the reins
of the Privacy Department too. The leadership at the department has a sub-unit for compliance
headed by Janelle Potter. She is in charge of ascertaining that the data collected through different
systems such as the RPM devices is collected in compliance with existing laws and used within
those laws. For instance, the firm’s official communication on data usage on its website notes
that the information collected is at times used to optimize performances, fulfill orders, send
newsletters, for RPM services, and other uses (Mayo Clinic, 2020). In particular, the firm adopts
the European Economic Area (EEA) and Switzerland standards and guidelines when it comes to
protecting children’s privacy as well as respecting the rights of patients.
Initial Funding for RPM

10. 10
The RPM program at Mayo Clinic has received funding from multiple sources at
different times. The first instance of an RPM program at the firm was funded by the well-wishers
and sponsors of the entity. Given that the Clinic is a nonprofit organization that operates as a
public charity, it had to seek additional funders. The Clinic partnered with Arizona State
University to jointly run the first instance of RPM through the MedTech Accelerator in 2019.
Through this partnership, the Clinic received funding from six companies that had to pay
$50,000 in first-round financing (Rahimi et al., 2017). The initial funding of the firm was
reported to be $500,000. This funding was put to good use. The company accelerated the
program leading to a fully operational RPM by end of 2020. This program was hampered by the
demands of COVID-19 but the additional funding from the FCC of $1 million helped to expand
the use of RPM to cancer patients, and COVID-19 patients at the same time. Before the funding,
the organization was admittedly struggling to meet the demands for all patients through the RPM
in the wake of COVID-19 (Gannon, 2020). In the end, the funding secured in the first-round
financing was enough to put the program up with additional funding later on helping to bolster
the program.
Budget Management
Budget management at Mayo clinic is a responsibility that is undertaken on three
different levels. Firstly, the Mayo Clinic Board of Governors which doubles as the Executive
Committee of Board of Trustees (MCBOG) is expected to develop and overseeing system-wide
annual operating budgets. This responsibility also includes oversight over system-wide cash flow
and capital expenditure management. Secondly, the Board of Trustees is expected to approve
both the operating and capital budgets of the firm. They are also expected to determine the long-
term financial goals of the entity.

11. 11
Thirdly, the President and Chief Executive Officer of the organization has the
responsibility of providing financial stewardship of the firm. As such they are required to
oversee annual operating budgets including cash flows and capital expenditures. Some of these
roles overlap with each other. As a result, the organization’s flow of authority as per the
hierarchy chosen is that the MCBOG takes oversight power over the budget. The second in
command in that regard is the Board of Trustees. The CEO takes the third position in terms of
making decisions regarding the budget (Mayo Clinic, 2019). This means that the CEO’s
decisions can be overridden by the Board of Trustees whose decisions can in turn be overridden
by the MCBOG.
Political/organizational Issues
At Mayo Clinic, political issues have rarely affected the activities of the clinic. In 2018,
the clinic distanced itself from ads that dragged its name between Republican candidate Jim
Hagedorn and Dan Feehan on the Democratic ticket. The hospital made it clear that it did not
share either have a political interest in that context (MedCity Beat, 2018). This culture of
steering free of political issues has enabled the hospital to perform on a good level with
important decisions being made fairly faster (Traczyńska & Kunecka, 2018). It is also the reason
why the firm has been quick in making decisions.
Organizational issues are minimal at the number one hospital in the United States. This
Clinic is led by individuals with medical experience and knowledge. This makes it possible for
the firm to have decisions that are medically appropriate and well-informed. This is how the firm
arrived at installing the RPM and continually improving this endeavor over the years. S well,
because the Clinic is led by people with medical understanding, all partners to the RPM program
have added value to the program from a medical perspective (Runtu et al., 2019). Of greatest

12. 12
importance is the fact that the decisions made at the hospital are targeted at improving the
medical services and not profit-oriented.
Arrangements for Possible Downtimes
Mayo Clinic utilizes a robust IT framework. As reported on the website, the firm has in
place a backup solution to cover possible downtimes. Firstly, the firm has a proactive
maintenance schedule on all operating systems at the firm. As well, the RPM system undergoes a
pre-business system check. Additionally, there are measurements and indicators to reduce the
impact of unplanned downtime. These are serviceability, availability, reliability, and
maintainability. Through these measures, the systems are used regularly to reduce the frequency
of unplanned downtimes. Thirdly, the systems at Mayo are subject to an event monitoring
process. Through it, monitoring memory utilization helps to lower downtimes (Yousefli, Nasiri
& Moselhi, 2020). As well server-related downtimes causes are addressed through this process.
Planning for RPM Upgrades
The upgrades of the RPM system are made in two main ways. Firstly, the system is fitted
with an automatic upgrade scheduling feature. This feature identifies the need for upgrades in
terms of servers and memory on the disks used (Karahanna et al., 2019). These upgrades are
well-structured and the organization is warned well in advance when the tie for an upgrade is
near.
The second method of scheduling upgrades is based on the IT department’s discretion.
They can identify areas that require urgent upgrades. When such upgrades are identified, the
organization’s IT department schedules the upgrade on a timely basis. These upgrades are often
rolled out independently from the running system to make sure that there is no disruption of

13. 13
service (Karahanna et al., 2019). The end-user is asked to update the app to receive those
updates.
Changes in RPM
The RPM system has evolved since it was first developed and rolled out at Mayo Clinic.
The firm’s leadership on this project has been identifying strategic partners to help push the
service further. In recent times, the RPM has proved essential in fighting COVID-19 at the
Clinic. Through the Remote Diagnostic and Management Platform (RDMP) the firm has been
able to collect data from patients to help manage their symptoms at a safe distance. The
scalability of the RMP program at the firm has been commended because it has helped to lower
the risks incurred by nurses and doctors in monitoring COVID-19 patients (Wicklund, 2021).
The success achieved has shown that the RPM system has a strong future at the Clinic.
Recommended Changes
One challenge identified by Hassan et al. (2019) is the director of the RMP is that the
system has been the accessibility to mHealth devices by affected patients. The main goal of the
RPM system is to facilitate medical services scalability to patients with low access to such
services. However, part of the reason why such patients may have low accessibility to medical
services is their incomes. With low incomes, such households are also not able to access the
mHealth devices that Mayo Clinic uses to facilitate the RMP system. Additionally, the cost of
accessing the RMP services through the Mayo Clinic is also high for some households. Thus, it
is recommended that government subsidies and other sources of additional funding be
accelerated to lower the costs of making RPM a service for all.
Innovative Aspects of the System
RPM’s Utilization of Innovations

14. 14
There have been multiple innovations in the medical area that the RPM system leverages.
As per the FDA policy, a complete RPM system should utilize all of the following devices:
electronic thermometers, cardiac monitors, electroencephalographs, electrocardiographs,
audiometers, spirometers, apnea monitors, electronic stethoscopes, oximeters, and blood pressure
monitors. This is one of the clinic’s side (Grubic & Jennions, 2018; Health Quality Ontario.,
2018).
On the patient’s side of the system, the following innovations are often required to
achieve success. Firstly, the patient must have devices that are BLE compatible to facilitate the
exchange of data with those devices. As well, patients’ devices that are supplied by the Clinic or
sold separately have to be EIC 62304 compliant (Grubic & Jennions, 2018). This is a guideline
meant to specify the requirement for devices on safety for medical software.
Other than those aspects, cloud computing innovation is leveraged. It makes it possible to
lower the chances of downtimes because of the storage fundamental of the system in the cloud
(Grubic & Jennions, 2018). This means it is scalable to any part of the world so long as both the
patient and the doctor have access to the cloud through the internet.
Further, the web application that facilitates the interaction between the patients and
doctors has to be compliant with HIPAA standards. These standards have specific demands for
web applications in a hospital with regard to how an EMR system is used as well as the
management of the hospital’s API (Yue et al., 2020). Any changes to these innovations are to be
rolled onto the RPM system immediately to prevent a possible data breach or other negative
externalities. These aspects together form the Mayo Clinic’s remote patient monitoring system
ecosystem. It is as shown in the figure below.
Figure 2: Remote Patient Monitoring System

15. 15
Source; Mayo Clinic (2020).
The system as shown in Figure 2, is designed to comply with all medical policies on data
management. It is also designed to facilitate the flow of information in a smooth manner from
the patient to the doctor while maintaining a high level of security. This is why the RPM system
at Mayo Clinic is based on FDA and HIPAA compliance (Mayo Clinic, 2020). Unfortunately,
the compliance costs are high making the service costs for the patients
Recommendable Technological Innovations
One technological innovation, I would recommend in light of the cost challenge faced
with the RPM system is a smartwatch. This device can be made to incorporate most of the
features need in collecting diagnostic data. These include information such as heartbeat rate and
blood pressure. The company can strike a partnership with a company like Samsung, OnePlus, or
Apple to make affordable smartwatches that would meet the FDA guidelines (Garg, 2021). Such
watches would be used to connect the patient to the RPM without having to pay for expensive
devices. This way, the cost of access to the RPM would be lowered significantly. This way, a

16. 16
huge number of patients would join the program to increase the overall access to Mayo Clinic’s
medical services across the US and elsewhere in the world.
Another innovation would be drone technology. This innovation can be leveraged in
delivering medicines to patients and other materials. The biggest challenge facing RPM as a
service is that it often leads to the need for the patient to take certain medicines. The main goal of
RPM is to bring medical services to all patients, but specifically to patients who have mobility
issues or other problems limiting their capacity to visit the hospital regularly. For such patients,
asking them to go buy medicine to take samples of their stool or blood to the hospital would
defeat the purpose of the system. However, by adopting drone technologies, doctors can send
medicines to patients into their homes while patients can send samples to the doctor through the
same drones (Garg, 2021). Thus, Mayo Clinic should find ways through which this technological
innovation can be adopted to improve the RPM system. It would eliminate the current weakness
of this system.
Promoting Evidence-Based Practice and Efficiency at Mayo Clinic
The RPM system serves two major purposes. It connects patients to doctors miles away.
It is also designed to collect ample information from those patients to help doctors and nurses to
make informed decisions. Thus, the RPM’s strict measures of execution as aided by the FDA and
HIPAA guidelines promote evidence-based practice. This is because doctors and nurses indicate
their diagnosis on the application for other doctors to lead. This means that all decisions have to
be informed by the evidence provided by the patient as well as evidence from previous cases as
determined by the medical practitioners.

17. 17
References
Annis, T., Pleasants, S., Hultman, G., Lindemann, E., Thompson, J. A., Billecke, S., ... &
Melton, G. B. (2020). Rapid implementation of a COVID-19 remote patient monitoring
program. Journal of the American Medical Informatics Association, 27(8), 1326-1330.
Center for Connected Care. (2019). About Center for Connected Care | Cleveland Clinic.
Cleveland Clinic. https://my.clevelandclinic.org/departments/connected-care/about
Ellsworth, M. A., Aakre, C. A., Dziadzko, M., Peters, S. G., Pickering, B. W., & Herasevich, V.
(2016, July). Early computerization of patient care at Mayo Clinic. In Mayo Clinic
Proceedings (Vol. 91, No. 7, pp. e93-e101). Elsevier.
Gannon, S. (2020, October 7). Mayo Clinic details remote monitoring program for COVID-19
patients. KTTC. https://kttc.com/2020/10/06/mayo-clinic-details-remote-monitoring-
program-for-covid-19-patients/
Garg, N. (2021). Technology in Healthcare: Vision of Smart Hospitals. In Handbook of Research
on Engineering, Business, and Healthcare Applications of Data Science and
Analytics (pp. 346-362). IGI Global.
Griggs, K. N., Ossipova, O., Kohlios, C. P., Baccarini, A. N., Howson, E. A., & Hayajneh, T.
(2018). Healthcare blockchain system using smart contracts for secure automated remote
patient monitoring. Journal of medical systems, 42(7), 1-7.
Grubic, T., & Jennions, I. (2018). Remote monitoring technology and servitised strategies–
factors characterizing the organizational application. International Journal of Production
Research, 56(6), 2133-2149.
Haddad, T. C., Blegen, R. N., Prigge, J. E., Cox, D. L., Anthony, G. S., Leak, M. A., ... &
Demaerschalk, B. M. (2021). A scalable framework for telehealth: The Mayo Clinic

18. 18
Center for connected care response to the COVID-19 pandemic. Telemedicine
Reports, 2(1), 78-87.
Hassan, M. K., El Desouky, A. I., Elghamrawy, S. M., & Sarhan, A. M. (2019). Big data
challenges and opportunities in healthcare informatics and smart hospitals. In Security in
smart cities: Models, applications, and challenges (pp. 3-26). Springer, Cham.
Hathaliya, J., Sharma, P., Tanwar, S., & Gupta, R. (2019, December). Blockchain-based remote
patient monitoring in healthcare 4.0. In 2019 IEEE 9th International Conference on
Advanced Computing (IACC) (pp. 87-91). IEEE.
Health Quality Ontario. (2018). Remote monitoring of implantable cardioverter-defibrillators,
cardiac resynchronization therapy, and permanent pacemakers: a health technology
assessment. Ontario health technology assessment series, 18(7), 1.
Karahanna, E., Chen, A., Liu, Q. B., & Serrano, C. (2019). Capitalizing on health information
technology to enable digital advantage in US hospitals. MIS Quarterly, 43(1), 113-140.
Malasinghe, L. P., Ramzan, N., & Dahal, K. (2019). Remote patient monitoring: a
comprehensive study. Journal of Ambient Intelligence and Humanized Computing, 10(1),
57-76.
Masterson, L. (2018). Mayo Clinic reports $12B in revenue for 2017. Healthcare Dive.
https://www.healthcaredive.com/news/mayo-clinic-reports-12b-in-revenue-for-
2017/517571/
Mayo Clinic Staff. (2019). Mayo Clinic privacy policy. Mcmapp.mayoclinic.org.
https://mcmapp.mayoclinic.org/content/PrivacyPolicy.htm
Mayo Clinic. (2019). About Us - Mayo Clinic Governance. Mayo Clinic.
https://www.mayoclinic.org/about-mayo-clinic/governance

19. 19
Mayo Clinic. (2020). A Foundation for Health Care Reform Legislation MAyo CLiniC’s Point
oF View. https://www.mayoclinic.org/documents/viewpoint4-pdf/doc-20079677
Mayo Clinic. (2020b). Mayo Clinic Q&A podcast: Remote monitoring for COVID-19 patients.
Www.youtube.com. https://www.youtube.com/watch?v=f387QBiRsoQ&t=2s
MedCity Beat. (2018). Mayo’s name gets dragged into partisan politics. Med City Beat.
https://www.medcitybeat.com/news-blog/2018/mayo-clinic-not-endorsing-candidates
Noah, B., Keller, M. S., Mosadeghi, S., Stein, L., Johl, S., Delshad, S., ... & Spiegel, B. M.
(2018). Impact of remote patient monitoring on clinical outcomes: an updated meta-
analysis of randomized controlled trials. NPJ digital medicine, 1(1), 1-12.
Rahimi, H., Kavosi, Z., Shojaei, P., & Kharazmi, E. (2017). Key performance indicators in
hospital-based on balanced scorecard model. Journal of Health Management &
Informatics, 4(1), 17-24.
Runtu, T. M., Novieastari, E., & Handayani, H. (2019). How does organizational culture
influence care coordination in hospitals? A systematic review. Enfermeria Clinica, 29,
785-802.
Traczyńska, K., & Kunecka, D. (2018). Organizational culture in nursing teams based on the
example of a particular hospital. Progress in Health Sciences, 8, 46-54.
Vegesna, A., Tran, M., Angelaccio, M., & Arcona, S. (2017). Remote patient monitoring via
non-invasive digital technologies: a systematic review. Telemedicine and e-Health, 23(1),
3-17.
Wicklund, E. (2021, April 14). Mayo Clinic Launches New Platform for Analyzing Data From
mHealth Devices. MHealthIntelligence. https://mhealthintelligence.com/news/mayo-
clinic-launches-new-platform-for-analyzing-data-from-mhealth-devices

20. 20
Yousefli, Z., Nasiri, F., & Moselhi, O. (2020). Maintenance workflow management in hospitals:
An automated multi-agent facility management system. Journal of Building
Engineering, 32, 101431.
Yue, W., Voronova, L. I., & Voronov, V. I. (2020, March). Design and implementation of a
remote monitoring human health system. In 2020 Systems of Signals Generating and
Processing in the Field of on Board Communications (pp. 1-7). IEEE.