New research also found paradoxically higher readmission rates among older patients enrolled in remote monitoring - a finding researchers say warrants immediate clinical attention.
PITTSBURGH - The largest randomized trial ever conducted on remote patient monitoring - technology that lets clinicians track patients' vital signs and symptoms from home - found that none of four monitoring approaches reduced 90-day post-discharge hospital readmissions compared with usual follow-up care for sepsis survivors. The trial also found paradoxically higher readmission rates among older patients who received remote monitoring.
Results from the ACCOMPLISH trial, which enrolled 1,286 adults over nearly four years, were published June 11, 2026, in JAMA Network Open and presented the same day at the Critical Care Reviews annual meeting in Belfast by researchers from the University of Pittsburgh and UPMC Health Plan.
The trial tested four remote patient monitoring (RPM) models - combining short or long symptom questionnaires with standard or enhanced clinical response teams - against UPMC's usual post-discharge care. Usual care typically included a post-discharge nurse call and continued management with a primary care physician.
Sepsis is a life-threatening condition triggered by the body's extreme response to an infection, which can damage organs. It is one of the leading causes of preventable hospital readmissions in the United States. Patients discharged after sepsis or lower respiratory tract infection often face months of lingering complications, making the transition home a critical and vulnerable period.
"Health systems, insurers and policymakers all want to reduce hospital readmissions, and most patients prefer to recover safely at home," said lead author Sachin Yende, M.D., M.S., professor of critical care medicine at Pitt's School of Medicine. "Remote monitoring has been held up as a solution, is reimbursed by the Centers for Medicare & Medicaid Services (CMS) and its use has grown. But, aside from a few conditions, there's a dearth of high-quality data to show it reduces readmissions."
What the Trial Found
The 90-day sepsis readmission rate ranged from 36.3% in patients who received the long questionnaire with enhanced clinical response to 44.2% among those who received the long questionnaire with standard clinical response. The usual-care control group had a 37.8% readmission rate. None of the differences reached statistical significance.
Younger patients showed a modest trend toward benefit. But older patients who received RPM had paradoxically higher readmission rates - a finding Yende said the team will investigate further.
The enhanced clinical response arm included certified registered nurse practitioners with palliative care expertise who could coordinate care directly and had access to social workers - a nursing-led model that expanded on the standard nurse-triage approach.
The trial was made possible by the unique integration of Pitt's research infrastructure and UPMC's role as both health care provider and health insurer. That structure allowed researchers to deploy and evaluate interventions from hospitalization through months of post-discharge recovery, drawing on both clinical and claims data.
"This complex trial was possible because UPMC is both a health care provider and insurer," study co-author said Kristin Mayes, M.S., program administrator at UPMC Health Plan's Center for High-Value Health Care. "This allows us - with patient and member permission - to deploy interventions even after the patient is discharged from the hospital and seamlessly learn from their experiences over time to see if those interventions worked."
Yende noted that the strength of UPMC's usual post-discharge care - including evidence-based nurse follow-up and personalized primary care - may help explain why remote monitoring offered little incremental benefit. He said that model could serve as a blueprint for other health systems designing post-discharge programs.
The ACCOMPLISH trial used a pragmatic design, enrolling patients under real-world clinical conditions to produce findings that reflect how these interventions actually perform in practice. The findings indicate health systems should reevaluate remote monitoring programs for this patient population, and that technology developers should consider designs better tailored to the complex recovery needs of sepsis survivors.
Frequently Asked Questions
Q: Did remote patient monitoring help any sepsis patients in this trial?
A: Younger patients showed a modest trend toward benefit from remote monitoring. However, older patients had paradoxically higher readmission rates in the monitoring arms, and no intervention reached statistical significance compared with standard follow-up care.
Q: Why didn't remote monitoring reduce readmissions if CMS already reimburses it?
A: CMS reimbursement reflects coverage policy, not necessarily clinical effectiveness for every condition. The ACCOMPLISH trial found that, for sepsis and lower respiratory tract infection patients, current remote monitoring designs did not outperform UPMC's already strong usual care, which included nurse follow-up and personalized primary care management.
Q: What should health systems do with these findings?
A: The researchers say health systems should evaluate whether their remote monitoring programs are producing measurable readmission reductions specifically for sepsis patients, and should exercise caution before enrolling older or high-complexity patients until further analysis clarifies the higher readmission rates observed in this trial.
Additional Resources
- Published study: ACCOMPLISH trial results in JAMA Network Open
- ACCOMPLISH Trial: Comparative Effectiveness of Readmission Reduction Interventions for Individuals with Sepsis or Pneumonia | ClinicalTrials.gov
- Hospital Discharge: What to Expect on the Day of Hospital Discharge | UPMC HealthBeat
- Press Release: Remote Patient Monitoring Didn't Cut Sepsis Readmissions, Largest Trial Finds | EurekAlert
- Headshots: Dr. Sachin Yende and Kristin Mayes
