Continuous Remote Patient Monitoring Shows Early Cardiovascular Changes in COVID-19 Patients

COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This retrospective multi-center observational cohort study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable providing continuous remote patient monitoring of numerous vital signs. The study was conducted in five COVID-19 isolation units. A total of 492 COVID-19 patients were included in the final analysis. Physiological parameters were measured every 15 min. More than 3 million measurements were collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. Cardiovascular deterioration appeared early after admission and in parallel with changes in the respiratory parameters, showing a significant difference in trajectories within sub-populations at high risk. Early detection of cardiovascular deterioration of COVID-19 patients is achievable when using frequent remote patient monitoring.

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Remote Patient Monitoring Using Radio Frequency Identification (RFID) Technology and Machine Learning for Early Detection of Suicidal Behaviour in Mental Health Facilities

Sensors ◽

10.3390/s21030776 ◽

2021 ◽

Vol 21 (3) ◽

pp. 776

Author(s):

Xiaohui Tao ◽

Thanveer Basha Shaik ◽

Niall Higgins ◽

Raj Gururajan ◽

Xujuan Zhou

Keyword(s):

Mental Health ◽

Machine Learning ◽

Radio Frequency Identification ◽

Patient Monitoring ◽

Vital Signs ◽

Remote Patient Monitoring ◽

Rfid Technology ◽

Rpm System ◽

Frequency Identification ◽

Remote Patient

Remote Patient Monitoring (RPM) has gained great popularity with an aim to measure vital signs and gain patient related information in clinics. RPM can be achieved with noninvasive digital technology without hindering a patient’s daily activities and can enhance the efficiency of healthcare delivery in acute clinical settings. In this study, an RPM system was built using radio frequency identification (RFID) technology for early detection of suicidal behaviour in a hospital-based mental health facility. A range of machine learning models such as Linear Regression, Decision Tree, Random Forest, and XGBoost were investigated to help determine the optimum fixed positions of RFID reader–antennas in a simulated hospital ward. Empirical experiments showed that Decision Tree had the best performance compared to Random Forest and XGBoost models. An Ensemble Learning model was also developed, took advantage of these machine learning models based on their individual performance. The research set a path to analyse dynamic moving RFID tags and builds an RPM system to help retrieve patient vital signs such as heart rate, pulse rate, respiration rate and subtle motions to make this research state-of-the-art in terms of managing acute suicidal and self-harm behaviour in a mental health ward.

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Low-power radio telemetry: the potential for remote patient monitoring

Journal of Telemedicine and Telecare ◽

10.1258/1357633961930059 ◽

1996 ◽

Vol 2 (4) ◽

pp. 185-191 ◽

Cited By ~ 14

Author(s):

W G Scanlon ◽

N E Evans ◽

G C Crumley ◽

Z M Mccreesh

Keyword(s):

Patient Monitoring ◽

Radio Telemetry ◽

Vital Signs ◽

Clinical Results ◽

Full Duplex ◽

Remote Patient Monitoring ◽

Monitoring Equipment ◽

Future Developments ◽

Remote Patient

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.

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A Review on Wearable and Contactless Sensing for COVID-19 With Policy Challenges

Frontiers in Communications and Networks ◽

10.3389/frcmn.2021.636293 ◽

2021 ◽

Vol 2 ◽

Author(s):

Sagar Suresh Kumar ◽

Kia Dashtipour ◽

Qammer H. Abbasi ◽

Muhammad A. Imran ◽

Wasim Ahmad

Keyword(s):

Patient Monitoring ◽

Vital Signs ◽

Risk Groups ◽

Developed Countries ◽

Cross Infection ◽

Remote Patient Monitoring ◽

Healthcare Facilities ◽

Emergency Situations ◽

The Us ◽

Remote Patient

The COVID-19 pandemic has affected more than 100 million people worldwide, with around 500,000 cases reported daily. This has led to the overwhelming of healthcare systems even in developed countries such as the US, UK, etc. Remote monitoring of COVID-19 patients with non-serious symptoms can help reduce the burden on healthcare facilities and make them available for high risk groups and the seriously affected. The pandemic has accelerated the demand for the remote patient monitoring (RPM) technologies, and the market is expected to reach 2.14 billion in 2027 from the value of 786.4 million in 2019. In RPM programs, there are two types of sensors that can be used: wearable and contactless. The former, which is currently more widely used, is not only more obtrusive and uncomfortable, but can also lead to cross-infection through patient contact. These two types of technologies are discussed and compared for each vital sign. In the respiratory system, the vital signs are the respiratory rate (RR) and oxygen saturation (SpO2), while for the latter, they are the heart rate/rhythm and the blood pressure (BP). Then, the discussion is broadened to policy level changes needed to expedite the use of such technologies for remote patient monitoring (RPM) in the world. Around 80% of countries' RPM programs are either informal or in a pilot phase, and thus lack policies and an established regulatory framework to implement their programs. The various policies needed to initiate, deliver, and reimburse RPM programs during emergency situations and outbreaks are discussed. Finally, technologies such as contactless systems, robotics, and Internet-of-things (IoT) that will revolutionize healthcare in the future by reducing the interaction between physicians and patients and cross-infection are discussed.

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Towards Evaluating the Quality of Experience of Remote Patient Monitoring Services

Healthcare Ethics and Training ◽

10.4018/978-1-5225-2237-9.ch056 ◽

2017 ◽

pp. 1183-1215

Author(s):

Lea Skorin-Kapov ◽

Ognjen Dobrijevic ◽

Domagoj Piplica

Keyword(s):

Patient Monitoring ◽

Quality Of Experience ◽

Blood Pressure Measurement ◽

Vital Signs ◽

Smartphone Application ◽

Mobile Technologies ◽

Remote Patient Monitoring ◽

Service Usage ◽

Remote Patient

The applicability of advanced mobile technologies in the m-Health domain has led to a number of studies and (limited) commercial products supporting delivery of health services to remote users. A key issue regarding successful delivery and acceptance of such services is meeting their Quality of Service (QoS) and Quality of Experience (QoE) requirements, focusing on technical aspects and end user perceived quality, respectively. In this paper, the authors address the topic of evaluating QoE for non-emergency remote patient monitoring services. They identify relevant QoE influence factors and metrics, and present the results of a QoE evaluation study, whereby they focus on usability aspects. The study involves 26 users testing a prototype version of the Ericsson Mobile Health service, which is based on a smartphone application and measurement of vital signs via medical sensors. The results show a strong correlation between QoE and: perceived effectiveness of the mobile interface (regarding both adequacy of smartphone screen size and smartphone application navigational support), perceived ease of conducting a blood pressure measurement task, and user motivation for service usage.

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MEDLINK: a low-cost, portable, verbally interactive and programmable remote patient monitoring (RPM) device

BMJ Innovations ◽

10.1136/bmjinnov-2019-000371 ◽

2020 ◽

Vol 6 (4) ◽

pp. 151-158

Author(s):

O'tega Ejofodomi ◽

Jason Zara ◽

Godswill Ofualagba

Keyword(s):

Patient Monitoring ◽

Low Cost ◽

Text Messages ◽

Physiological Parameters ◽

Security And Privacy ◽

Physiological Parameter ◽

Remote Patient Monitoring ◽

Blood Oxygen Saturation ◽

Biomedical Sensors ◽

Remote Patient

Remote patient monitoring (RPM) devices are a novel method for physicians to monitor their patients after discharge and long after they have gone home. Usually RPM devices are bulky, relatively expensive, restricted in the physiological parameters they measure and are hard to operate.MEDLINK is a low cost (~$C1500), verbally interactive, programmable and portable RPM device that possesses the ability to verbally interact with a physician to obtain his or her information as well as the patient’s key statistics, and then to obtain the physician’s selection of physiological parameters he or she wishes to remotely monitor from that particular patient. When the patient switches on the unit, MEDLINK also verbally interacts with the patient to measure and acquire the physician’s selected physiological parameter and sends this information to the physician’s phone, via text messages and emails. Security and privacy of patient’s medical data can be preserved by using the patient’s ID instead of patient name.Physiological parameters that can be acquired by MEDLINK include: ECG, blood pressure, heart rate, blood glucose, pulse rate, blood oxygen saturation, electromyography, body temperature, spirometer, respiratory rate and much more. Future work involves the integration of more biomedical sensors to the existing MEDLINK product to expand its range of measurable physiological parameters to its maximum, and to conduct a short clinical trial on the product prior to commercialisation.

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Outpatient practice pattern and remote patient monitoring for axicabtagene ciloleucel CAR-T therapy in patients with aggressive lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.7554 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 7554-7554

Author(s):

Radhika Bansal ◽

Jonas Paludo ◽

Adam Holland ◽

Spychalla Megan ◽

McClanahan Alli ◽

...

Keyword(s):

Median Time ◽

Patient Monitoring ◽

Vital Signs ◽

Aggressive Lymphoma ◽

Remote Patient Monitoring ◽

T Cell Therapy ◽

Early Admission ◽

Patient Reported ◽

Car T ◽

Remote Patient

7554 Background: Chimeric antigen receptor T-cell therapy (CAR-T) are commonly administered inpatient due to concern for early onset cytokine release syndrome (CRS), especially with axicabtagene ciloleucel (axi-cel). We report Mayo Clinic Rochester experience for hospital-based outpatient (HBO) management of patients (pts) receiving axi-cel and identify opportunities for improvement. HBO is closely integrated with inpatient practice and includes the same specialty trained clinical team. It is the first point of contact 24/7 for pts and triage evaluations. Lymphodepletion chemotherapy and CAR-T infusion is given on HBO followed by daily monitoring till day 8 and thereafter, as clinically needed until admission criteria is met. Methods: We retrospectively analyzed database of pts who received axi-cel between 1/2018 and 1/2021. After 06/2020, remote patient monitoring (RPM) tools were implemented to collect patient-reported neurologic symptoms and vital signs via bluetooth-enabled devices 4 times daily through month 1. Adverse data trends are addressed by the HBO team. Results: Among 72 recipients, 89% received their cells outpatient; 8% remained outpatient for the entire month. CRS and neurotoxicity incidence were comparable to those reported from CIBMTR. Median time to first admission was 2 days (Table). Use of bridging therapy, increased CRP and LDH were associated with early admission (≤3 days). Median time to tocilizumab, steroid, oxygen support, vasopressor was 4 days after admission. Half of HBO visits required intervention such as blood transfusions, IV medications through the first month. Nine pts had enrolled in RPM to date; with 8 having evaluable data. With 4 scheduled entries/day, a median of 1 entry/day was skipped and 2 entries/day were answered incompletely. An average of 57 additional unscheduled entries were generated per pt. Among a median of 373 (range 91-522) readings per pt over the first month, 4% (2%-20%) of the readings generated alerts. An average of 4 alerts were seen within 48 hours prior to admission. Data including additional subjects will be presented at ASCO meeting. Conclusions: We report a feasible outpatient care model for management of axi-cel recipients with safe outcomes. Clinical characteristics associated with more aggressive disease are associated with likelihood of early admission. Early RPM experience suggest use of digital tools could improve monitoring compliance and may predict evolution to symptoms requiring escalation of care.[Table: see text]

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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.

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Towards Evaluating the Quality of Experience of Remote Patient Monitoring Services

International Journal of Mobile Human Computer Interaction ◽

10.4018/ijmhci.2014100104 ◽

2014 ◽

Vol 6 (4) ◽

pp. 59-89 ◽

Cited By ~ 5

Author(s):

Lea Skorin-Kapov ◽

Ognjen Dobrijevic ◽

Domagoj Piplica

Keyword(s):

Patient Monitoring ◽

Quality Of Experience ◽

Blood Pressure Measurement ◽

Vital Signs ◽

Smartphone Application ◽

Mobile Technologies ◽

Remote Patient Monitoring ◽

Service Usage ◽

Remote Patient

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Trajectories of Key Physiological Parameters in COVID-19 Patients Using Continuous Remote Monitoring and Health AI

10.21203/rs.3.rs-122775/v1 ◽

2020 ◽

Author(s):

Arik Eisenkraft ◽

Yasmin Maor ◽

Keren Constantini ◽

Nir Goldstein ◽

Dean Nachman ◽

...

Keyword(s):

Remote Monitoring ◽

Vital Signs ◽

Blood Oxygen ◽

Cardiorespiratory System ◽

Blood Oxygen Saturation ◽

Frequent Monitoring ◽

Respiratory Parameters ◽

Multi Center Study ◽

First Time ◽

Worse Prognosis

Abstract Coronavirus disease 2019 (COVID-19) exerts deleterious effects on the cardiorespiratory system, leading to worse prognosis in the most effected. The aim of this retrospective multi-center study was to describe the variability of key cardiopulmonary vitals amongst hospitalized COVID-19 patients, measured every 15 minutes using a novel wearable chest-monitor. A total of 492 patients were included, with >3 million measurements collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. We show differential trajectories of these vital signs, apparent within the first 24hrs of monitoring. Importantly, we show for the first time that cardiovascular deterioration appears early after admission and in parallel with changes in the respiratory parameters, and identify sub-populations at high risk. Combining frequent monitoring using wearable technology with advanced big data and AI analysis tools may aid early detection of deterioration of COVID-19 patients.

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Using Push Notification in Telehealth and Remote Patient Monitoring Systems

Carpathian Journal of Electronic and Computer Engineering ◽

10.2478/cjece-2018-0013 ◽

2018 ◽

Vol 11 (2) ◽

pp. 20-24

Author(s):

Honoriu Valean ◽

Cola Cristian ◽

Andrei Wegroszta ◽

Cristinel Costea

Keyword(s):

Patient Monitoring ◽

Vital Signs ◽

Raspberry Pi ◽

Monitoring Systems ◽

Android Application ◽

Remote Patient Monitoring ◽

Health Monitoring System ◽

Patient Monitoring Systems ◽

Remote Patient ◽

Cardiac Pulse

Abstract This paper discusses mobile notifications in the context of health monitoring system that measure and store vital signs of the patient that are included in this program. The values measured are temperature and cardiac rhythm. This has two Android application, one is used by the patient to monitor his vital signs and the other is used by the physician to be able to see and receive push notifications of each individual patient. The sensors are connected to a Raspberry Pi and these devices send information to the Android smartphone via Bluetooth. The physician can monitor patient data in real time. All the information that is gathered by the smartphone from the sensors are sent to the cloud, can project a history and can detect some anomalies, for example, if the cardiac pulse is not within the limits of an accepted interval.

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