2025 Chronic Disease Monitoring Report: Contactless Vital Signs in Long-Term Care Management

Chronic diseases account for 90% of the $4.1 trillion the United States spends annually on healthcare, according to the CDC. Six in ten American adults have at least one chronic condition, and four in ten have two or more. Globally, the WHO estimates that chronic diseases cause 74% of all deaths. These numbers have been cited so often that they've lost their capacity to shock — but the management challenge they represent remains as urgent as ever.

The central tension in chronic disease management is frequency of monitoring versus burden of monitoring. Optimal management of heart failure requires daily weight and vital sign checks. COPD management benefits from regular respiratory rate and oxygen tracking. Hypertension control demands frequent blood pressure readings. But every measurement that requires a device — a scale, a cuff, a pulse oximeter, a peak flow meter — introduces friction that erodes compliance over time. And in chronic disease, compliance is everything.

"The greatest challenge in chronic disease management is not the lack of effective treatments, but the inability to maintain consistent monitoring and timely intervention over the months and years that chronic conditions require." — Grady et al., Circulation (2000)

The Compliance Crisis in Chronic Disease Monitoring

The evidence for remote monitoring in chronic disease is strong — the evidence for sustained patient engagement with monitoring devices is not:

Condition	Recommended Monitoring	Device Required	Reported Long-Term Compliance	Key Barrier
Heart Failure	Daily weight + vitals	Scale, BP cuff, SpO2	40-60% at 6 months (Ong et al., 2016)	Multiple device fatigue
COPD	Regular SpO2 + RR	Pulse oximeter, peak flow	50-70% initially, declining	Device complexity
Hypertension	2x daily BP readings	BP cuff	50-65% at 12 months (Omboni et al., 2013)	Cuff discomfort, routine fatigue
Diabetes (Type 2)	Regular glucose checks	Glucometer or CGM	Variable — CGM higher than SMBG	Finger-prick pain, cost
Atrial Fibrillation	Pulse checks or ECG	ECG monitor or smartwatch	Low for intermittent monitoring	Forgetting, inconvenience

Sources: Ong et al. JAMA IM (2016), Omboni et al. (2013), Vegesna et al. (2017), published RPM compliance studies.

The pattern is consistent: compliance is highest in the first weeks, then declines steadily as the novelty wears off and the burden persists. By 6-12 months — which is the relevant timeframe for chronic disease — a significant portion of patients have stopped regular monitoring. Camera-based measurement, requiring only a 30-second daily phone scan with no equipment to find, charge, calibrate, or wear, addresses the compliance equation directly.

Condition-Specific Applications

Heart Failure

Heart failure management is perhaps the strongest clinical use case for contactless vital sign monitoring. The condition affects 6.2 million Americans (Virani et al., AHA, 2021) and has 30-day readmission rates above 20%. Effective outpatient management requires tracking:

• Heart rate trends — rising resting HR signals decompensation
• HRV — declining HRV precedes clinical symptoms by days (Adamson, 2009)
• Respiratory rate — tachypnea is an early sign of fluid overload
• SpO2 — falling oxygen levels indicate pulmonary congestion

All four are measurable through camera-based rPPG from a single scan. Adamson (2009) documented that physiological changes detectable through monitoring preceded heart failure hospitalizations by a median of 14 days — a substantial intervention window.

Chronic Obstructive Pulmonary Disease (COPD)

COPD affects an estimated 380 million people worldwide (Adeloye et al., Lancet Respiratory Medicine, 2022) and generates approximately 700,000 US hospitalizations annually. Exacerbation detection depends heavily on respiratory monitoring:

• Respiratory rate elevation is one of the earliest exacerbation signals
• Breathing pattern changes — irregular, labored breathing precedes acute episodes
• Heart rate elevation — compensatory tachycardia accompanies respiratory distress
• SpO2 decline — oxygen desaturation signals worsening airflow obstruction

Researchers including Massaroni et al. (2019) have specifically noted camera-based respiratory monitoring as promising for COPD home management due to its ability to capture rate, pattern, and regularity without chest straps.

Hypertension

With 1.28 billion adults affected globally (WHO), hypertension is the most prevalent chronic condition requiring vital sign monitoring. Blood pressure measurement remains the most challenging rPPG application, but the frequency advantage is significant — even directional BP trends from daily camera scans provide more data than the once-monthly clinic visit most hypertensive patients receive.

Diabetes and Metabolic Health

While camera-based glucose estimation remains experimental, the related vital signs measurable through rPPG — heart rate, HRV (which correlates with autonomic neuropathy progression), and stress levels — provide metabolic health context that complements traditional glucose monitoring.

The Economic Case

The economics of contactless chronic disease monitoring are compelling:

Traditional RPM programs cost $100-200 per patient per month in equipment and logistics. Camera-based monitoring is software-only, eliminating device procurement, shipping, replacement, and technical support costs. For health systems managing thousands of chronic disease patients, this cost difference is substantial.

CMS reimburses RPM under codes 99453-99458, generating $120-240 per patient per month in revenue for qualifying programs. If camera-based monitoring meets the data transmission requirements for RPM billing — which requires regular physiological data capture and clinical review — the margin improvement over device-based programs is significant.

More importantly, preventing a single heart failure readmission (average cost: $15,200 per HCUP data) pays for months of monitoring infrastructure. The value equation favors monitoring almost regardless of modality — and the modality with the highest sustained compliance generates the most value over time.

Integration with Clinical Workflows

Effective chronic disease monitoring requires more than data collection — it requires clinical response workflows:

• Intelligent alerting: Trending algorithms that detect meaningful deterioration patterns rather than single outlier readings
• Risk stratification: Prioritizing clinical attention toward patients showing the most concerning trends
• EHR integration: Vital sign data flowing into the electronic health record alongside medication lists, lab results, and clinical notes
• Patient engagement: Simple, consistent user experience that becomes part of daily routine
• Care team dashboards: Aggregate views that let nurses and care managers efficiently monitor patient panels

The Road Ahead

Chronic disease management is fundamentally a compliance and data frequency problem. The treatments work when patients are monitored, deterioration is caught early, and interventions are timely. Every barrier between the patient and regular vital sign data reduces the effectiveness of the entire care model.

Companies like Circadify are developing camera-based vital sign monitoring for chronic disease management platforms, enabling multi-vital-sign capture from a single smartphone scan. The technology addresses the compliance crisis that has limited RPM effectiveness by eliminating the equipment burden entirely. For a healthcare system spending $4 trillion annually — with 90% going to chronic conditions — even marginal improvements in monitoring adherence translate to significant clinical and economic impact.

Frequently Asked Questions

Which chronic conditions benefit most from contactless vital sign monitoring?

Heart failure, COPD, hypertension, and diabetes show the strongest evidence for RPM benefit. These conditions require frequent vital sign tracking where patient compliance with traditional devices is a primary barrier.

How does contactless monitoring improve chronic disease outcomes?

Camera-based monitoring removes equipment barriers, enabling more frequent vital sign capture. Higher data frequency allows earlier detection of physiological deterioration, prompting timely intervention before acute events requiring hospitalization.

Is contactless monitoring sufficient for chronic disease management?

Contactless vital signs are one component of comprehensive chronic disease management, which also includes medication adherence, lifestyle modification, and regular clinical evaluation. Camera-based monitoring enhances but does not replace the full care model.

Related Articles

• Remote Patient Monitoring Reduces Readmissions — RPM evidence for reducing hospital readmissions across chronic conditions.
• Contactless Heart Rate Monitoring — Heart rate trending is foundational to chronic disease monitoring across conditions.
• Contactless Respiratory Rate Detection — Respiratory monitoring is critical for COPD and heart failure management.