Wyles Daniel
Image Credit: Toca Health
Dr. Dayan Gandhi’s clinical career has focused on caring for patients with chronic kidney disease whose conditions often change outside the exam room. As a practicing Nephrologist and healthcare leader, he saw firsthand that many patients face real barriers to frequent in-person visits, even when they are actively engaged in their care. These experiences led him to question how care could better extend beyond the clinic setting. TOCA Health, a Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) company, grew out of that insight, founded to support more continuous, patient-centered care between visits while staying aligned with the realities of everyday medical practice.
“Across healthcare, chronic care has traditionally been organized around episodic encounters,” Dr. Gandhi shares. “Patients often see their physicians only a limited number of times each year, and those visits are typically brief.” Within that narrow window, he notes that clinicians must review symptoms, assess trends, adjust treatments, and address patient concerns, all while relying heavily on memory or isolated measurements. “Between appointments, however, chronic conditions continue to change. Blood pressure can fluctuate, glucose levels may vary, symptoms might emerge or fade, and adherence can be uneven,” Dr. Gandhi adds. The absence of structured insight during these intervals can sometimes make it difficult for care teams to understand how a condition is progressing.
These observations are supported by recent research. The Quality of Care: Chronic Conditions Almanac(2024) emphasizes that chronic conditions such as diabetes, hypertension, and obesity remain persistent and are associated with preventable hospitalizations and disparities in health outcomes.
Studies examining care delivery highlight how structural and daily-life constraints can limit access to care. For example, a 2025 nationally representative analysis found that adults who reported delaying medical care due to transportation barriers were more likely to use the emergency department and had a higher risk of adverse health outcomes, including increased all-cause mortality, particularly among those with chronic conditions.
Qualitative research among low-income patients with chronic conditions highlights how structural barriers, such as unreliable or costly transportation, can make it difficult to attend medical appointments and access healthcare or nutrition programs. Participants described strategies to cope with these challenges, showing that these obstacles are realities that affect daily life and care engagement.
According to Dr. Gandhi, remote monitoring has increasingly been discussed as one way to narrow this gap. A 2025 systematic review showed that remote patient monitoring for people with chronic noncommunicable diseases was associated with lower proportions of hospitalizations and shorter hospital stays compared with usual care, indicating that remotely tracking health status outside of traditional clinic visits may help bridge access gaps for patients who struggle to attend in‑person appointments.
“At-home measurement allows patients to capture information in familiar environments. It reflects how their bodies respond to everyday routines rather than clinical settings alone,” he states. Dr. Gandhi adds that when shared appropriately with care teams, this information can offer a more continuous picture of health.
Building on these findings, TOCA Health integrates remote monitoring into a practical workflow. Its model combines connected devices, software for organizing data, and care managers who engage patients. This structure reflects the company’s understanding that data alone doesn’t create clarity. Interpretation, communication, and clinical context remain essential.
Dr. Gandhi remarks, “Information is only helpful when it reaches the right person, in the right form, at the right time.” That philosophy translates into workflows designed to show meaningful changes without requiring physicians to continuously monitor raw data streams. Care managers act as an intermediary layer, reviewing trends, contacting patients when readings fall outside expected ranges, and escalating information to clinicians when appropriate.
TOCA Health stresses that when clinicians have access to summarized, longitudinal information, conversations can shift. Instead of reconstructing months of symptoms from memory, physicians and patients can review shared data and focus on decisions. “Those few minutes together become more meaningful when you’re not guessing what happened in between,” Dr. Gandhi says.
Ultimately, the shift toward remote monitoring reflects a broader reframing of chronic care from a series of isolated encounters to a continuous, supportive relationship. It recognizes that living with chronic illness involves daily decisions, fluctuations, and uncertainties. Technology, as demonstrated by TOCA Health, provides a way to stay connected to these realities while minimizing burden for both patients and care teams.