Article

Withings Remote Patient Monitoring Program – An Outcomes Analysis on Hypertension

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This paper aims to analyze the impact of Withings Remote Patient Monitoring (RPM) programs on hypertension and hypertensive crisis management in patients with or at risk of developing hypertension. The study comprises 1,873 patients over 6 months, who followed an RPM program and used Withings Blood Pressure Monitors.

Hypertension, defined by the World Health Organization (WHO) as a blood pressure level of ≥ 140/90 mmHg, is the most prevalent chronic disease globally, affecting approximately 1.28 billion adults aged 30-79 years. If left untreated, hypertension can lead to severe complications, including heart failure, chronic kidney disease, and various heart diseases such as atrial fibrillation, coronary heart disease, and valvular heart disease. Given that hypertension often presents minimal to no symptoms but carries significant health risks, frequent and continuous blood pressure monitoring is crucial for hypertensive patients and those at risk.

 

This study examines the challenge of hypertension in the United States, affecting nearly half of the adult population, with a significant portion remaining untreated or non adherent to medication. Withings’ Remote Patient Monitoring (RPM) program offers a solution by enabling healthcare professionals to remotely access patients’ health records and monitor blood pressure readings through Withings Blood Pressure Monitors (BPM Connect or BPM Connect Pro). This facilitates personalized treatment plans and improves medication adherence among hypertensive patients. The study evaluates the effectiveness of Withings RPM programs on managing hypertension, involving 3377 patients across 50 programs, highlighting the potential of remote monitoring in enhancing patient health outcomes.

Dataset

The dataset for this study was obtained from Withings, and is composed of all users following an RPM program, and owning at least one of the Withings Blood Pressure Monitors ; this may include patients at risk of or with hypertension, taking medication or attempting to reduce their medication doses. The data set is composed of 1877 users, they are 18 or older, they are in Europe or USA.

 

Patients included in this study took their in-home BP measurements using the Withings BPM Connect or the BPM Connect Pro devices. They are clinically-validated devices measuring BP and HR using the cuff oscillometric method.

 

The data exploration was performed using Python v3.9.6. The plots were built using matplotlib, and the statistical analysis performed using statsmodels. Potential covariates, including age, sex and BMI were analyzed, but not accounted for in the study.

Classification according to BP levels

This study separates tension into five distinct categories, following guidelines from the American Heart Association (AHA), as shown in table 1 below.

User Activity
Descriptive statistics

Figure 1 presents the distribution of users according to the five different hypertensive categories, in the first week of their enrolment in the program. This shows that approximately a third of users (647 users) experience Grade 2 Hypertension in their first week. Grade 3 hypertension, which represents extreme hypertension, represents 12% of the population (225 users). Among this category, 9% (21 users) experience an average hypertension ≥ 180/120 mmHg, which are classified as hypertensive crises, and present a life-threatening risk.

Hypertension Trajectories, based on Initial BP Levels

Figure 2 presents the mean difference in blood pressure at each relative week rank, with respect to week 1, averaged across all users by hypertension category. The graphs indicate a clear reduction in both systolic and diastolic pressures over time for patients with Grade 2 and Grade 3 Hypertension, suggesting effective management or treatment. Patients with Grade 1 Hypertension maintain relatively stable blood pressure levels, indicating controlled hypertension. Conversely, patients with normal and elevated blood pressure categories exhibit slight increases in both systolic and diastolic pressures over time. To understand the implications of this, it would be interesting to collect further information on the patients at hand : were they enrolled in the program to monitor their reduction in medication, or because they were at risk of developing hypertension, for example due to underlying comorbidities ?

Hypertension Trajectories of Blood Pressure, based on Measure Frequency

Further than the initial level of hypertension, it is relevant to investigate whether the frequency and consistency of measures has an impact on blood pressure management. The frequency of measures was based upon quartile information :

  • Very Consistent users : More than 5.5 measures a week (Q3)
  • Consistent users : Between 3 and 5.5 measures a week (IQR)
  • Inconsistent users : Less than 3 measures a week (Q1)

Figure 4 shows the mean difference in blood pressure at each relative week rank with respect to week 1, averaged across all users, by frequency of measures.

Hypertensive Crises Trajectories
As aforementioned, approximately 1% of users experience a mean BP > 180/120 mmHg in their first week of measures (which includes at least three measures). Furthermore, amongst the entire cohort, a total of 673 users (28.6%) experience a hypertensive crisis. This is an abnormally high proportion, compared to indications from several sources, which state that approximately 1% of hypertensive patients experience a hypertensive crisis. It is therefore a major point of interest is to quantify the reduction in the percentage of users experiencing crises over time, as presented in figure 5.

This study provides a comprehensive analysis of the evolution of hypertension over six months in a cohort of 1,873 patients using the Withings Remote Patient Monitoring (RPM) program, in conjunction with Withings Blood Pressure Monitors. The findings underscore the potential of consistent and continuous self-monitoring on hypertension management. Patients who adhered to the program’s recommendations and consistently took their blood pressure measurements experienced significant reductions in both systolic and diastolic blood pressure levels. This highlights the potential benefits of RPM programs hypertension management, likely due to improving medication adherence and better informed decisions by doctors.

 

The study also revealed a higher-than-expected prevalence of hypertensive crises among the cohort, suggesting the need for a closer monitoring of hypertensive crises in patients at risk.

 

Future research should focus on identifying factors that influence patient engagement and motivation, such as the quality of onboarding, the frequency of contact with care teams and the treatment duration. Additionally, collecting more detailed information on patient backgrounds and program features will help to better understand the observed trends and improve the effectiveness of RPM programs.

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Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine. Among the many challenges faced by these patients, cardiovascular disease (CVD) stands out as the leading cause of mortality—a stark reminder of the systemic stress that accompanies kidney failure and dialysis.

 

But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? An article in Frontiers in Nephrology explores exactly that—highlighting the transformative potential of digital health technologies to monitor and manage CKD5D patients beyond the clinic.

 

The Hidden Risks Between Dialysis Sessions

For CKD5D patients, the risks of CVD are amplified by both traditional and disease-specific factors:

 

  • Traditional risks like hypertension, diabetes, and obesity.

  • CKD-specific risks such as inflammation, fluid overload, protein-energy wasting and vascular calcification.

  • The dialysis process itself, which induces rapid fluid shifts, blood pressure fluctuations, and metabolic imbalances.

Current clinical care models often focus on in-center dialysis data, leaving a crucial blind spot during the interdialytic period—a time when many adverse events begin to develop unnoticed.

 

A New Monitoring Paradigm: The Withings Toolkit

The article introduces a compelling case for home-based, connected health technologies—specifically, the Withings toolkit. This suite of medical-grade, consumer-friendly devices allows CKD patients to monitor key health indicators in the comfort of their homes:

 

  • Weight, body composition and ECG monitoring with the BodyScan smart scale.

  • Blood pressure, heart rate and survey responses for added context via BPM Pro 2.

  • Sleep quality and breathing event metrics using the Sleep Rx.

All data is seamlessly uploaded to the Withings Remote Patient Monitoring platform, providing healthcare providers and researchers with real-time, longitudinal insights into a patient’s well-being.

 

Why This Matters: Real-World Clinical Benefits

1. Early Detection of Complications

Weight gain could signal fluid retention, but muscle loss could indicate protein-energy wasting. A sudden spike in blood pressure or irregular heartbeat might indicate arrhythmias or volume overload. Poor sleep patterns could reflect apnea or restless leg syndrome—conditions with known ties to CKD.

2. Personalized, Data-Driven Care

These devices enable a dynamic view of health trends, allowing clinicians to tailor treatments proactively rather than reactively. Medication adjustments, fluid restrictions, or further diagnostics can be made with greater confidence.

3. Patient Empowerment

When patients can see and understand their own data, they become more engaged in their care. This promotes better self-management, increased treatment adherence, and a stronger sense of control over their condition.

4. Systemic Healthcare Advantages

Remote monitoring can reduce emergency visits and hospitalizations, easing the burden on overtaxed healthcare systems and offering a cost-effective alternative to frequent in-person evaluations.

 

The Future: Digital Tools as Standard of Care?

While still in its early stages, this integration of digital health into CKD care reflects a broader movement toward remote, preventative, and personalized medicine. The Withings case study serves as a promising example of how everyday technology can be adapted to serve complex clinical needs.

 

However, as the authors note, more clinical trials are needed to validate these tools in nephrology settings, establish protocols for data use, and ensure equitable access across diverse patient populations.

 

Final Thoughts

As we face growing rates of kidney disease and limited nephrology resources, connected health technologies offer a lifeline—not just to patients, but to an entire care infrastructure in need of modernization.

 

The Withings toolkit is more than a gadget suite; it's a glimpse into the future of chronic disease management, where data flows continuously, care is adaptive, and patients are active participants in their own health journey.

 

References
Article: Frontiers in Nephrology, 2023 - DOI: 10.3389/fneph.2023.1148565

Interested in partnering with us?

Contact Us [post_title] => Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study [post_excerpt] => Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine.But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => revolutionizing-chronic-kidney-disease-management-with-digital-health-tools-the-withings-case-study [to_ping] => [pinged] => [post_modified] => 2025-06-12 15:41:31 [post_modified_gmt] => 2025-06-12 15:41:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2015 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 2012 [post_author] => 11 [post_date] => 2025-06-03 19:17:23 [post_date_gmt] => 2025-06-03 19:17:23 [post_content] =>

Introduction

 

Diabetic foot ulcers (DFUs) are a major and often debilitating complication of diabetes, contributing significantly to patient morbidity, mortality, and healthcare costs. Despite advancements in diabetes care, the incidence of DFUs remains high, with a substantial impact on quality of life and healthcare resources. A recent study published in the journal Frontiers in Endocrinology compared the use of electrochemical skin conductance (ESC) to the current standards in DFU detection. The current method for assessing DFU risk primarily involves clinical examination, including the monofilament test, which is subjective and dependent on the examiner’s skills. Therefore, there is a need for objective, reproducible, and reliable methods for early detection of at-risk patients.

 

One of the many complications of diabetes is peripheral neuropathy, which, if left untreated, can lead to DFUs. Electrochemical Skin Conductance (ESC) is a promising non-invasive diagnostic tool that can be used to assess autonomic nerve activity. ESC is measured in-clinic using Sudoscan, which assesses small fiber peripheral neuropathies, specifically the innervation around the sweat glands, by stimulating the glands and measuring the conductance (in µS) of chloride ions contained in the sweat. Lower ESC values indicate more severe neuropathy. This study investigates the association between ESC and DFU risk stratification, offering a potential new approach to managing and preventing diabetic foot complications.

Methods

 

This study was a retrospective analysis involving 2,149 diabetic patients from four clinics in Greater Paris University Hospitals, the largest hospital system in Europe and one of the largest in the world. The primary aim was to evaluate the relationship between ESC measurements and DFU risk, as classified using the 2016 International Working Group on Diabetic Foot (IWGDF) grading system. This grading system assigns DFU risk based on clinical evaluation, including the presence of neuropathy, ulceration, and other factors.

To assess the predictive performance of ESC in DFU risk stratification, the study incorporated a range of factors: age, sex, type of diabetes, and results from the monofilament test, which is a standard assessment of peripheral neuropathy. The study employed regression and Receiver Operating Characteristic (ROC) analyses to explore the predictive value of ESC measurements for different DFU risk categories.

 

Results

 

The study revealed a significant correlation between ESC values and DFU risk grades (p<0.001). Specifically, lower FESC values were associated with higher grades of DFU risk, suggesting that reduced sweat gland function, indicative of small fiber neuropathy, plays a role in the progression of foot ulcers in diabetic patients.

 

One of the most noteworthy findings of this study was that ESC measurements were able to identify patients at risk for DFUs who would not have been classified as high risk using the standard IWGDF grading system. Specifically, ESC detected autonomic dysfunction and small fiber nerve involvement in 43% patients classified as grade 0 (13% with severe cases of neuropathy), who otherwise showed no obvious signs of risk through traditional assessments, showing better granularity in the lower grades for better risk stratification.

 

The findings of this study suggest that Electrochemical Skin Conductance (ESC) provides a valuable, reproducible, and operator-independent tool for assessing DFU risk. ESC measurements offer an objective method for identifying early signs of small fiber neuropathy, a critical factor in the development of DFUs. Unlike traditional risk stratification, which relies heavily on clinical judgment and may overlook early-stage neuropathy, ESC can detect subtle changes in nerve function that precede visible foot ulcers.

 

The ability of ESC to detect at-risk patients in the grade 0 category, who would otherwise be overlooked by conventional classification methods, highlights its potential role in preventing DFUs. By identifying patients with early-stage nerve dysfunction, ESC could facilitate earlier intervention, potentially reducing the incidence of foot ulcers, amputations, and associated healthcare costs.

 

The ability to detect DFU risk early using ESC shows promise for the prevention of amputation.Therefore, we conclude that feet skin conductance is a relevant parameter for detecting diabetic foot syndrome, specifically at an early stage when there is still no presence of feet ulceration or wounds. A recent meta-analysis on ESC supports this conclusion, indicating that ESC, when combined with temperature measurements, serves as a valuable tool for the early detection of diabetic foot syndrome. ESC can be measured in-clinic, using Sudoscan, and at home using Withings Body Pro 2. Measuring ESC through home use of the Body Pro 2 scale allows for additional data collection and better assessment of trends and progression between appointments. Through this enhanced monitoring of DFU risk, care teams can better risk-stratify and provide targeted care that could prevent amputations and complications.

Interested in partnering with us?

Contact Us [post_title] => Electrochemical Skin Conductance as a Novel Tool for Diabetic Foot Ulcer Risk Stratification and Prevention [post_excerpt] => Diabetic foot ulcers (DFUs) are a major and often debilitating complication of diabetes, contributing significantly to patient morbidity, mortality, and healthcare costs.Electrochemical Skin Conductance (ESC) is a promising non-invasive diagnostic tool that can be used to assess autonomic nerve activity. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => electrochemical-skin-conductance-as-a-novel-tool-for-diabetic-foot-ulcer-risk-stratification-and-prevention [to_ping] => [pinged] => [post_modified] => 2025-06-16 13:31:21 [post_modified_gmt] => 2025-06-16 13:31:21 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2012 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 2005 [post_author] => 11 [post_date] => 2025-05-29 18:17:36 [post_date_gmt] => 2025-05-29 18:17:36 [post_content] =>

Menopause can significantly impact sleep, blood pressure, and body composition—and it goes far beyond hot flashes.

As estrogen and progesterone levels decline, the risk of obstructive sleep apnea (OSA) increases. These hormones help keep airway muscles strong and support stable breathing during sleep. When they drop, the airway is more likely to collapse during the night. Combined with menopause-related weight gain, this can significantly heighten the risk. According to the Sleep Foundation and Mayo Clinic, postmenopausal women are more prone to sleep apnea, even if they hadn’t previously experienced symptoms.

 

Menopause also increases the risk of hypertension. Lower estrogen levels reduce blood vessel flexibility, making it harder for blood to flow efficiently. Coupled with changes in weight, cholesterol, and insulin sensitivity, blood pressure tends to rise. The American Heart Association highlights that the risk of heart disease, including high blood pressure, climbs sharply in postmenopausal women—making routine monitoring all the more important.

 

Body composition also shifts during menopause. Fat tends to accumulate around the abdomen—even if overall weight remains stable—due to hormonal changes. This increase in visceral fat, which surrounds internal organs, is linked to elevated risks of cardiovascular disease, type 2 diabetes, and certain cancers. A University of Pittsburgh study found that for every 20% increase in abdominal fat, artery thickness, a key marker of heart disease risk, also increased. The Mayo Clinic reinforces the importance of addressing these changes through exercise, strength training, and healthy eating.

 

Monitoring these health changes is crucial for comprehensive menopause care. Withings Health Solutions can help. Withings offers clinically validated devices that make it easy to track vital health metrics from home. Body Pro 2 measures not just weight, but also body fat, visceral fat and muscle mass—providing a deeper understanding of your cardiovascular health. Sleep Rx aids in the detection of sleep apnea without requiring a wearable, while the BPM Pro 2 enables simple, accurate blood pressure monitoring.

 

Connected health devices offer a powerful way to enhance care and demonstrate measurable outcomes. As menopause impacts everything from sleep and blood pressure to weight and long-term cardiovascular health, cellular-connected devices—like Body Pro 2, BPM Pro 2, and Sleep Rx—enable real-time tracking of key metrics. These insights help patients and users better manage symptoms and allow care teams to personalize support. Just as importantly, aggregated health data can validate the impact of your solution, making it easier to show ROI to employers and insurers and improve engagement across populations.

Interested in partnering with us?

Contact Us [post_title] => The Need for Remote Patient Monitoring in Menopause Care [post_excerpt] => Menopause can significantly impact sleep, blood pressure, and body composition—and it goes far beyond hot flashes. Connected devices can enable comprehensive care and proof of ROI for menopause benefits. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-need-for-remote-patient-monitoring-in-menopause-care [to_ping] => [pinged] => [post_modified] => 2025-05-29 18:19:03 [post_modified_gmt] => 2025-05-29 18:19:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2005 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 2015 [post_author] => 11 [post_date] => 2025-06-12 15:39:12 [post_date_gmt] => 2025-06-12 15:39:12 [post_content] =>

Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine. Among the many challenges faced by these patients, cardiovascular disease (CVD) stands out as the leading cause of mortality—a stark reminder of the systemic stress that accompanies kidney failure and dialysis.

 

But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? An article in Frontiers in Nephrology explores exactly that—highlighting the transformative potential of digital health technologies to monitor and manage CKD5D patients beyond the clinic.

 

The Hidden Risks Between Dialysis Sessions

For CKD5D patients, the risks of CVD are amplified by both traditional and disease-specific factors:

 

  • Traditional risks like hypertension, diabetes, and obesity.

  • CKD-specific risks such as inflammation, fluid overload, protein-energy wasting and vascular calcification.

  • The dialysis process itself, which induces rapid fluid shifts, blood pressure fluctuations, and metabolic imbalances.

Current clinical care models often focus on in-center dialysis data, leaving a crucial blind spot during the interdialytic period—a time when many adverse events begin to develop unnoticed.

 

A New Monitoring Paradigm: The Withings Toolkit

The article introduces a compelling case for home-based, connected health technologies—specifically, the Withings toolkit. This suite of medical-grade, consumer-friendly devices allows CKD patients to monitor key health indicators in the comfort of their homes:

 

  • Weight, body composition and ECG monitoring with the BodyScan smart scale.

  • Blood pressure, heart rate and survey responses for added context via BPM Pro 2.

  • Sleep quality and breathing event metrics using the Sleep Rx.

All data is seamlessly uploaded to the Withings Remote Patient Monitoring platform, providing healthcare providers and researchers with real-time, longitudinal insights into a patient’s well-being.

 

Why This Matters: Real-World Clinical Benefits

1. Early Detection of Complications

Weight gain could signal fluid retention, but muscle loss could indicate protein-energy wasting. A sudden spike in blood pressure or irregular heartbeat might indicate arrhythmias or volume overload. Poor sleep patterns could reflect apnea or restless leg syndrome—conditions with known ties to CKD.

2. Personalized, Data-Driven Care

These devices enable a dynamic view of health trends, allowing clinicians to tailor treatments proactively rather than reactively. Medication adjustments, fluid restrictions, or further diagnostics can be made with greater confidence.

3. Patient Empowerment

When patients can see and understand their own data, they become more engaged in their care. This promotes better self-management, increased treatment adherence, and a stronger sense of control over their condition.

4. Systemic Healthcare Advantages

Remote monitoring can reduce emergency visits and hospitalizations, easing the burden on overtaxed healthcare systems and offering a cost-effective alternative to frequent in-person evaluations.

 

The Future: Digital Tools as Standard of Care?

While still in its early stages, this integration of digital health into CKD care reflects a broader movement toward remote, preventative, and personalized medicine. The Withings case study serves as a promising example of how everyday technology can be adapted to serve complex clinical needs.

 

However, as the authors note, more clinical trials are needed to validate these tools in nephrology settings, establish protocols for data use, and ensure equitable access across diverse patient populations.

 

Final Thoughts

As we face growing rates of kidney disease and limited nephrology resources, connected health technologies offer a lifeline—not just to patients, but to an entire care infrastructure in need of modernization.

 

The Withings toolkit is more than a gadget suite; it's a glimpse into the future of chronic disease management, where data flows continuously, care is adaptive, and patients are active participants in their own health journey.

 

References
Article: Frontiers in Nephrology, 2023 - DOI: 10.3389/fneph.2023.1148565

Interested in partnering with us?

Contact Us [post_title] => Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study [post_excerpt] => Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine.But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => revolutionizing-chronic-kidney-disease-management-with-digital-health-tools-the-withings-case-study [to_ping] => [pinged] => [post_modified] => 2025-06-12 15:41:31 [post_modified_gmt] => 2025-06-12 15:41:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2015 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 48 [max_num_pages] => 16 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => 1 [is_tag] => [is_tax] => [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => dfa280649d5ed2d1d28df3e212e868f0 [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [allow_query_attachment_by_filename:protected] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) [query_cache_key:WP_Query:private] => wp_query:f8de9353637f7422a705dd8873279212:0.07090400 17501368020.11439800 1750136802 )
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Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study

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Withings On-The-Go

Our patient-centric care solution utilizes portable Withings cellular devices that are not tied to a single patient. Instead, care teams can use one device to collect and transmit data for an unlimited number of individuals. The integrated cellular connectivity automatically directs the data into the correct patient’s medical record, simplifying data collection and improving care delivery regardless of the setting.