The impact of gender, medical history and vital status on emergency visits and hospital admissions: A remote patient monitoring case study

Radio-based signalling devices will play an important role in future generations of remote patient monitoring equipment, both at home and in hospital. Ultimately, it will be possible to sample vital signs from patients, whatever their location and without them necessarily being aware that a measurement is being taken. This paper reviews current methods for the transmission by radio of physiological parameters over ranges of 0.3, 3 and 30 m, and describes the radiofrequency hardware required and the carrier frequencies commonly used. Future developments, including full duplex systems and the use of more advanced modulation schemes, are described. The paper concludes with a case study of a human temperature telemeter built to indicate ovulation. Clinical results clearly show the advantage to be had in adopting radio biotelemetry in this instance.

Download Full-text

Rapid implementation of a COVID-19 remote patient monitoring program

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocaa097 ◽

2020 ◽

Vol 27 (8) ◽

pp. 1326-1330 ◽

Cited By ~ 14

Author(s):

Tucker Annis ◽

Susan Pleasants ◽

Gretchen Hultman ◽

Elizabeth Lindemann ◽

Joshua A Thompson ◽

...

Keyword(s):

Patient Monitoring ◽

Hospital Admissions ◽

Education Technology ◽

Monitoring Program ◽

Remote Patient Monitoring ◽

Emergency Room Visits ◽

Educational Materials ◽

Virtual Care ◽

Remote Patient ◽

Technology Solution

Abstract Objective The study sought to evaluate early lessons from a remote patient monitoring engagement and education technology solution for patients with coronavirus disease 2019 (COVID-19) symptoms. Materials and Methods A COVID-19–specific remote patient monitoring solution (GetWell Loop) was offered to patients with COVID-19 symptoms. The program engaged patients and provided educational materials and the opportunity to share concerns. Alerts were resolved through a virtual care workforce of providers and medical students. Results Between March 18 and April 20, 2020, 2255 of 3701 (60.93%) patients with COVID-19 symptoms enrolled, resulting in over 2303 alerts, 4613 messages, 13 hospital admissions, and 91 emergency room visits. A satisfaction survey was given to 300 patient respondents, 74% of whom would be extremely likely to recommend their doctor. Discussion This program provided a safe and satisfying experience for patients while minimizing COVID-19 exposure and in-person healthcare utilization. Conclusions Remote patient monitoring appears to be an effective approach for managing COVID-19 symptoms at home.

Download Full-text

Association of use of remote patient monitoring (RPM) with reduced hospitalizations in cancer patients with COVID-19.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.1503 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 1503-1503

Author(s):

Joshua Pritchett ◽

Aakash Desai ◽

Bijan J Borah ◽

Zhuoer Xie ◽

Antoine N Saliba ◽

...

Keyword(s):

Hospital Admission ◽

Cancer Patients ◽

Clinical Outcomes ◽

Patient Monitoring ◽

Severe Illness ◽

Remote Patient Monitoring ◽

Hospital Admission Rate ◽

Icu Admission ◽

Remote Patient ◽

The Impact

1503 Background: Patients with cancer and COVID-19 are at risk for poor clinical outcomes. An established multi-site remote patient monitoring (RPM) service was rapidly adapted to support a novel, interdisciplinary COVID-19 program for outpatient management of patients at high-risk for severe illness. The goal of this study was to assess the impact of the RPM program on clinical outcomes and acute care utilization in cancer patients diagnosed with COVID-19. Methods: This is a cross-sectional analysis following a multi-site prospective observational study performed at Mayo Clinic Cancer Center (MCCC). All adult patients with active cancer – defined as currently receiving cancer-directed therapy or in recent remission on active surveillance – and PCR-confirmed SARS-CoV-2 infection between March 18 and July 31, 2020 were included. RPM was comprised of in-home technology to assess symptoms and physiologic data with centralized nurse and physician oversight. Results: During the study timeframe 224 cancer patients were diagnosed with COVID-19 at MCCC. Initial management included urgent hospitalization (within 48 hours of diagnosis) in 34 patients (15%). Of the remaining 190 patients (85%) initially managed in the outpatient setting, those who did not receive RPM were significantly more likely to experience hospitalization than those receiving RPM (OR 3.6, 95% CI 1.036 to 12.01, P = 0.044). Following balancing of patient characteristics by inverse propensity weighting, rates of hospital admission for RPM and non-RPM patients were 3.1% and 11% respectively, implying that RPM was associated with an 8% reduction in hospital admission rate (-0.077; 95% CI: -0.315 to -0.019, P = 0.009). Use of RPM was also associated with lower rates of prolonged hospitalization, ICU admission, and mortality, though these trends did not reach statistical significance. Conclusions: In the midst of a global pandemic associated with inpatient bed, ventilator, and PPE shortages, the RPM program provided an effective strategy for outpatient clinical management and was associated with decreased rates of hospitalization, ICU admission, and mortality in cancer patients with COVID-19. This care model enabled simultaneous opportunity to mitigate the increased risks of exposure, transmission, and resource utilization associated with conventional care.

Download Full-text

Abstract P156: Improvement In Blood Pressure Using Remote Patient Monitoring During COVID19

Hypertension ◽

10.1161/hyp.76.suppl_1.p156 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Nadia A Liyanage-Don ◽

Joseph E Schwartz ◽

Nathalie Moise ◽

Kelsey B Bryant ◽

Adina Bono ◽

...

Keyword(s):

Blood Pressure ◽

Patient Monitoring ◽

Healthcare Access ◽

Vital Signs ◽

Primary Care Doctor ◽

Remote Patient Monitoring ◽

Nursing Support ◽

Before And After ◽

Remote Patient ◽

The Impact

Introduction: The coronavirus disease 2019 (COVID19) pandemic required strict social distancing to curb transmission. Unfortunately, these measures severely limited healthcare access and chronic disease management. In response, many health organizations rapidly developed or expanded telemedicine to provide care directly to patients at home. Little has been reported about the impact of such interventions on clinical outcomes during COVID19. We examined whether enrollment in a remote patient monitoring (RPM) program for hypertension (HTN) prior to COVID19 was associated with improved blood pressure during the pandemic. Methods: We developed an RPM program that tracked vital signs, medication side effects, and treatment adherence patterns outside of the clinic. Patients were referred by their primary care doctor for uncontrolled HTN or suspected white coat HTN. Patients received a two-way tablet, blood pressure cuff, and virtual nursing support via scheduled video visits. Those referred for uncontrolled HTN who had at least two weeks of data both before and after the onset of COVID19 (defined as the first two weeks of March 2020) were included in the study. A mixed-models analysis that adjusted for serial autocorrelation was used to compare mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) in the pre-/post-COVID19 periods. Results: Of 94 patients enrolled in the RPM program to date, 46 had at least two weeks of data both pre-COVID19 and post-COVID19. Mean age was 69.0 ± 10.9 years, 69.6% (32 of 46) were women, 78.3% (36 of 46) were Hispanic, and 63.0% (29 of 46) were Spanish-speaking. Pre-COVID, mean SBP was 132.31 ± 13.99 mmHg, mean DBP was 77.10 ± 9.87 mmHg, and 70% (32 of 46) of patients had uncontrolled BP (>130/80 mmHg per AHA guidelines). Post-COVID, mean SBP was 129.57 ± 13.29 mmHg, mean DBP was 76.00 ± 9.16 mmHg, and 57% (26 of 46) of patients had uncontrolled BP. There was a significant reduction in both mean SBP (β = –2.74, 95% CI –5.21, –0.26, p = 0.03) and mean DBP (β = –1.10, 95% CI –2.22, 0.02, p = 0.05) post-COVID vs. pre-COVID. Discussion: Despite the stress and social isolation associated with COVID19, participation in an RPM program that combines home BP monitoring with virtual nursing support can help maintain and even mildly decrease BP.

Download Full-text

The Impact of Remote Patient Monitoring (Telehealth) upon Medicare Beneficiaries with Heart Failure

Telemedicine Journal and e-Health ◽

10.1089/tmj.2011.0095 ◽

2012 ◽

Vol 18 (2) ◽

pp. 101-108 ◽

Cited By ~ 31

Author(s):

Renée Pekmezaris ◽

Irina Mitzner ◽

Kathleen R. Pecinka ◽

Christian N. Nouryan ◽

Martin L. Lesser ◽

...

Keyword(s):

Heart Failure ◽

Patient Monitoring ◽

Medicare Beneficiaries ◽

Remote Patient Monitoring ◽

Remote Patient ◽

The Impact

Download Full-text

Maximizing VA Remote Patient Monitoring During the COVID-19 Response

Telehealth and Medicine Today ◽

10.30953/tmt.v6.281 ◽

2021 ◽

Author(s):

Catherine Buck ◽

Rita Kobb ◽

Ron Sandreth ◽

Lisa Alexander ◽

Sherron Olliff ◽

...

Keyword(s):

Disease Management ◽

Large Scale ◽

Patient Monitoring ◽

The United States ◽

Health Administration ◽

Remote Patient Monitoring ◽

Management Protocol ◽

Remote Patient ◽

The Impact ◽

At Home

Abstract Objective: The Veterans Health Administration has one of the largest remote patient monitoring programs in the United States and is supported by an enterprise-wide infrastructure for providers, clinicians, staff, Veterans, and caregivers. The COVID-19 pandemic, however, presented new challenges: a sudden need to provide large-scale remote monitoring for a new disease that did not yet have a disease management protocol. VHA needed to be ready within weeks to provide this daily monitoring for hundreds — even thousands — of Veterans. Methods: The U.S. Department of Veterans Affairs Office of Connected Care already had a comprehensive infrastructure in place for its Remote Patient Monitoring – Home Telehealth (RPM – HT) program. Connected Care activated and built on this infrastructure to support providers, clinicians, and staff in their efforts to rapidly bring RPM – HT to Veterans across the nation when they had COVID-19 symptoms or exposure. To do this, Connected Care activated an emergency management plan, rapidly developed a new COVID-19-specific disease management protocol, added weekend monitoring, and procured critically needed monitoring supplies, such as thermometers and pulse oximeters. Connected Care’s strong foundation allowed for innovation and flexibility, such as the training of non-RPM – HT staff in RPM – HT processes, RPM – HT enrollment within acute care settings, and new strategic partnerships. Outcomes: More than 23,500 Veterans were enrolled for COVID-19-related monitoring from March 2020 to May 2021. At points in December 2020 and January 2021, the number of Veterans being monitored in a single day topped 2,000. Even with this rapid buildup, patient satisfaction levels remained at about 90% in numerous categories. In addition, the percentage of Veterans admitted to VA facilities while on COVID-19-related home monitoring has been extremely low, at 4%, a potential indicator that the monitoring system has been helpful in enabling Veterans who did have the virus to convalesce at home. Further study is needed to determine the impact RPM – HT enrollment for COVID-19 care had on the need for inpatient care. Conclusion: The Office of Connected Care’s established, enterprise-wide RPM – HT business, clinical, and technical infrastructure enabled VHA to enter the COVID-19 public health emergency well-positioned for the rapid deployment and growth of at-home and mobile monitoring. As the COVID-19 emergency made at-home management of Veterans increasingly important, the national RPM – HT program successfully adapted its practices to meet Veteran, caregiver, and staff needs.

Download Full-text

Water Removal Cycle-By-Cycle During Automated Peritoneal Dialysis: Assessment by Remote Patient Monitoring and Modelling of Peritoneal Tissue Hydration

10.21203/rs.3.rs-429738/v1 ◽

2021 ◽

Author(s):

Joanna Stachowska-Pietka ◽

Beata Naumnik ◽

Ewa Suchowierska ◽

Rafael Gomez ◽

Jacek Waniewski ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Patient Monitoring ◽

Water Removal ◽

Remote Patient Monitoring ◽

Automated Peritoneal Dialysis ◽

Fluid Exchange ◽

Tissue Hydration ◽

Peritoneal Tissue ◽

Remote Patient ◽

The Impact

Abstract Water removal which is a key treatment goal of automated peritoneal dialysis (APD) can be assessed cycle-by-cycle using remote patient monitoring (RPM). We analysed ultrafiltration patterns during night APD following a dry day (APDDD; no daytime fluid exchange) or wet day (APDWD; daytime exchange). Ultrafiltration for each APD exchange were recorded for 16 days using RPM in 14 patients. The distributed model of fluid and solute transport was applied to simulate APD and to explore the impact of changes in peritoneal tissue hydration on ultrafiltration. We found lower ultrafiltration (mL, median [first quartile-third quartile]) during first and second vs. consecutive exchanges in APDDD (-61 [-148—27], 170 [78—228] vs. 213 [126—275] mL; p<0.001), but not in APDWD (81 [-8—176], 81 [-4—192] and 115 [4—219] mL; NS). Simulations in a virtual patient showed that lower ultrafiltration (by 114 mL) was related to increased peritoneal tissue hydration caused by inflow of 187 mL of water during the first APDDD exchange. The observed phenomenon of lower ultrafiltration during initial exchanges of dialysis fluid in patients undergoing APDDD appears to be due to water inflow into the peritoneal tissue, re-establishing a state of increased hydration typical for peritoneal dialysis.

Download Full-text

Remote Patient Monitoring with Health Care Records Using Iot

International Research Journal of Multidisciplinary Technovation ◽

10.34256/irjmtcon12 ◽

2019 ◽

pp. 87-97

Author(s):

Valan Abisha J ◽

Abisha C ◽

Abirami S ◽

Reziga Susia J.

Keyword(s):

Medical Records ◽

Patient Monitoring ◽

Open Data ◽

Personal Digital Assistant ◽

Remote Patient Monitoring ◽

Novel Approach ◽

Decision Supporting ◽

Remote Patient ◽

Health Care Records

For a medical treatment with IoT-based facilities, physicians always have to pay much more attentions to the raw medical records of target patients instead of directly making medical advice, conclusions or diagnosis from their experiences. Because the medical records in IoT-based hospital information system (HIS) are dispersedly obtained from distributed devices such as tablet computer, personal digital assistant, automated analyzer, and other medical devices, they are raw, simple, weak-content, and massive. Such medical records cannot be used for further analyzing and decision supporting due to that they are collected in a weak-semantic manner. In this paper, we propose a novel approach to enrich IoT-based medical records by linking them with the knowledge in linked open data. A case study is conducted on a real-world IoT-based HIS system in association with our approach, the experimental results show that medical records in the local HIS system are significantly enriched and useful for healthcare analysis and decision making, and further demonstrate the feasibility and effectiveness of our approach for knowledge accessing.

Download Full-text