25,972 research outputs found

    Review of sensors for remote patient monitoring

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    Remote patient monitoring (RPM) of physiological measurements can provide an efficient method and high quality care to patients. The physiological signals measurement is the initial and the most important factor in RPM. This paper discusses the characteristics of the most popular sensors, which are used to obtain vital clinical signals in prevalent RPM systems. The sensors discussed in this paper are used to measure ECG, heart sound, pulse rate, oxygen saturation, blood pressure and respiration rate, which are treated as the most important vital data in patient monitoring and medical examination

    Internet-based training of coronary artery patients: the Heart Cycle Trial

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    © 2016, Springer Japan. Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System). This consisted of a sensor monitoring breathing rate and the electrocardiogram that transmitted information on training intensity, arrhythmias and adherence to training prescriptions, wirelessly via the internet, to a medical team that provided feedback and adjusted training prescriptions. Exercise capacity was evaluated prior to and 6 months after intervention. 118 patients (58 ± 10 years, 105 men) with CAD referred for CR were randomized (IG: n = 55, CG: n = 63). However, 15 patients (27 %) in the IG and 18 (29 %) in the CG withdrew participation and technical problems prevented a further 21 patients (38 %) in the IG from participating. No training-related complications occurred. For those who completed the study, peak VO 2 improved more (p = 0.005) in the IG (1.76 ± 4.1 ml/min/kg) compared to CG (−0.4 ± 2.7 ml/min/kg). A newly designed system for home-based CR appears feasible, safe and improves exercise capacity compared to national CR. Technical problems reflected the complexity of applying remote monitoring solutions at an international level

    EuroEco (European Health Economic Trial on Home Monitoring in ICD Patients): a provider perspective in five European countries on costs and net financial impact of follow-up with or without remote monitoring

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    Aim: Remote follow-up (FU) of implantable cardiac defibrillators (ICDs) allows for fewer in-office visits in combination with earlier detection of relevant findings. Its implementation requires investment and reorganization of care. Providers (physicians or hospitals) are unsure about the financial impact. The primary end-point of this randomized prospective multicentre health economic trial was the total FU-related cost for providers, comparing Home Monitoring facilitated FU (HM ON) to regular in-office FU (HM OFF) during the first 2 years after ICD implantation. Also the net financial impact on providers (taking national reimbursement into account) and costs from a healthcare payer perspective were evaluated. Methods and results: Atotal of 312 patients with VVI-or DDD-ICD implants from 17 centres in six EU countries were randomised to HMON or OFF, of which 303 were eligible for data analysis. For all contacts (in-office, calendar-or alert-triggered web-based review, discussions, calls) time-expenditure was tracked. Country-specific cost parameters were used to convert resource use into monetary values. Remote FU equipment itself was not included in the cost calculations. Given only two patients from Finland (one in each group) a monetary valuation analysis was not performed for Finland. Average age was 62.4 +/- 13.1 years, 81% were male, 39% received a DDD system, and 51% had a prophylactic ICD. Resource use with HM ON was clearly different: less FU visits (3.79 +/- 1.67 vs. 5.53 +/- 2.32; P < 0.001) despite a small increase of unscheduled visits (0.95 +/- 1.50 vs. 0.62 +/- 1.25; P < 0.005), more non-office-based contacts (1.95+3.29 vs. 1.01 +/- 2.64; P < 0.001), more Internet sessions (11.02 +/- 15.28 vs. 0.06 +/- 0.31; P < 0.001) and more in-clinic discussions (1.84 +/- 4.20 vs. 1.28 +/- 2.92; P < 0.03), but with numerically fewer hospitalizations (0.67 +/- 1.18 vs. 0.85 +/- 1.43, P = 0.23) and shorter length-of-stay (6.31 +/- 15.5 vs. 8.26 +/- 18.6; P = 0.27), although not significant. For the whole study population, the total FU cost for providers was not different for HM ON vs. OFF [mean (95% CI): (sic)204 169-238) vs. (sic)213 (182-243); range for difference ((sic)-36 to 54), NS]. From a payer perspective, FU-related costs were similar while the total cost per patient (including other physician visits, examinations, and hospitalizations) was numerically (but not significantly) lower. There was no difference in the net financial impact on providers [profit of (sic)408 (327-489) vs. (sic)400 (345-455); range for difference ((sic)-104 to 88), NS], but there was heterogeneity among countries, with less profit for providers in the absence of specific remote FU reimbursement (Belgium, Spain, and the Netherlands) and maintained or increased profit in cases where such reimbursement exists (Germany and UK). Quality of life (SF-36) was not different. Conclusion: For all the patients as a whole, FU-related costs for providers are not different for remote FU vs. purely in-office FU, despite reorganized care. However, disparity in the impact on provider budget among different countries illustrates the need for proper reimbursement to ensure effective remote FU implementation

    Advanced observation and telemetry heart system utilizing wearable ECG device and a Cloud platform

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    Short lived chest pain episodes of post PCI patients represent the most common clinical scenario treated in the Accidents and Emergency Room. Continuous ECG monitoring could substantially diminish such hospital admissions and related ambulance calls. Delivering community based, easy-To-handle, easy to wear, real time electrocardiography systems is still a quest, despite the existence of electronic electrocardiography systems for several decades. The PATRIOT system serves this challenge via a 12-channel, easy to wear, easy to carry, mobile linked, miniaturized automatic ECG device and a Cloud platform. The system may deliver high quality electrocardiograms of a patient to medical personnel either on the spot or remotely both in a synchronous or asynchronous mode, enhancing autonomy, mobility, quality of life and safety of recently treated coronary artery disease patients

    Implantable devices for heart failure monitoring: the CardioMEMSâ„¢ system.

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    Several devices have been developed for heart failure (HF) treatment and monitoring. Among device-based monitoring tools, CardioMEMSâ„¢ has received growing research attention. This document reflects the key points of an ESC consensus meeting on implantable devices for monitoring in HF, with a particular focus on CardioMEMSâ„¢

    Remote Monitoring of Implantable Cardioverter Defibrillator

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    The rate of implantable cardioverter defibrillator (ICD) implantation has gone up as primary and secondary prevention trials have relatively consistently shown significant improvement in mortality and morbidity. Most patients with ICDs are followed routinely at intervals ranging from 3 to 6 months. Many patients require additional non-scheduled visits to investigate symptoms that may or may not relate to their cardiac disease or device. Appropriate and inappropriate therapies of implantable cardioverter defibrillators have a major impact on morbidity and quality of life in ICD recipients. Remote monitoring systems can substitute for routine follow-up visits and/ or deliver continuous diagnostic and device status information. Remote monitoring of ICDs can decrease the need for many patient visits and, thereby, probably reduce expense

    New intelligent network approach for monitoring physiological parameters : the case of Benin

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    Benin health system is facing many challenges as: (i) affordable high-quality health care to a growing population providing need, (ii) patients’ hospitalization time reduction, (iii) and presence time of the nursing staff optimization. Such challenges can be solved by remote monitoring of patients. To achieve this, five steps were followed. 1) Identification of the Wireless Body Area Network (WBAN) systems’ characteristics and the patient physiological parameters’ monitoring. 2) The national Integrated Patient Monitoring Network (RIMP) architecture modeling in a cloud of Technocenters. 3) Cross-analysis between the characteristics and the functional requirements identified. 4) Each Technocenter’s functionality simulation through: a) the design approach choice inspired by the life cycle of V systems; b) functional modeling through SysML Language; c) the communication technology and different architectures of sensor networks choice studying. 5) An estimate of the material resources of the national RIMP according to physiological parameters. A National Integrated Network for Patient Monitoring (RNIMP) remotely, ambulatory or not, was designed for Beninese health system. The implementation of the RNIMP will contribute to improve patients’ care in Benin. The proposed network is supported by a repository that can be used for its implementation, monitoring and evaluation. It is a table of 36 characteristic elements each of which must satisfy 5 requirements relating to: medical application, design factors, safety, performance indicators and materiovigilance

    Using Technology to Enhance Rural Resilience in Pre-hospital Emergencies

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    The research presented in this paper is supported by RCUK dot.rural Digital Economy Research Hub, University of Aberdeen [grant number EP/G066051/1].Peer reviewedPublisher PD

    An Updated Rounds Checklist to Increase Appropriate Use of Telemetry Monitoring

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    Background: Telemetry monitoring is an essential tool to monitor cardiac electrical activity. Its overuse is costly in time and resources and leads to subsequent testing and treatments that are not necessary for the patient and, in addition, healthcare staff is burdened with work that is potentially not clinically useful. Aim: The global aim of increasing efficiency in telemetry use starts with the local improvement to facilitate nurse-physician communication of telemetry patients during Methods: This study with pre and post data collection looked at the results of quantitative data, collected in May-July 2015, on the number of patients with telemetry and the corresponding clinical indication before and after implementation of a modified rounds checklist which included telemetry as a discussion point. The new checklist was initiated on June 22, 2015 and post intervention data was gathered to determine if there was a decrease in the overuse of and increase in the appropriate use of telemetry. Results: With the implementation of the checklist the use of telemetry decreased, however the clinical indication for use did not improve. Conclusion and implications for CNL practice: After the implementation of the checklist criteria there has been a consistent decrease in telemetry use. This may attributable to improve nurse-physician communication, however, there is still a lack of appropriate clinical indication of use and the CNL, as lateral integrator, in future improvement projects, should support further modifications to the clinical indication set to improve appropriateness of telemetry use
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