Tele-Monitoring System for Chronic Diseases Management: Requirements and Architecture

In the last years a large variety of eHealth services and Apps for professional medical users have been developed for different scenarios. The increasing elderly population (+100% in 2050) makes urgent to implement tele-medicine paradigm in the healthcare structures. The need of monitoring large number of patients distributed over the territory, together with the lack of medical resources, makes the adoption of Information Communication Technologies (ICT) crucial for the future healthcare services. This paper presents an ICT architecture model for the provision of tele-monitoring services within a novel proposed remote monitoring concept for healthcare, considering the new Family and Community Nurse (FCN). An integrated and personalized tele-monitoring solution is presented, through a detailed description of the reference network architecture and service platform. Moreover, the preliminary results of the experimental activities carried out for the evaluation of the system in terms of usability in operational scenarios are provided.

ATTICUS: Ambient-Intelligent Tele-monitoring and Telemetry for Incepting and Catering Over hUman Sustainability

Wearable devices as medical technologies are becoming an integral part of our lives. Many research studies are dedicated to these devices and are mainly focused on providing personal analytics, measuring physical status, and acquiring physiological signals and parameters. These continuously evolving technologies play an important role in telemedicine. Telemedicine can be broadly defined as the use of advanced telecommunications technologies to support many medical activities, such as the diagnosis, the analysis of patient data, the improvement of disease management and the treatment in remote areas. In this article, we present ATTICUS (Ambient-intelligent Tele-monitoring and Telemetry for Incepting and Catering over hUman Sustainability), an innovative remote monitoring system for ambient-assisted living based on the analysis of vital and behavioral parameters. The ATTICUS system consists of two essential components: a smart wearable—in the form of a short singlet—made of innovative textile which allows the acquisition of real-time body signals, e.g., electrocardiogram (ECG), breathing wave, temperature, and a multi-level Decision Support System (DSS), a distributed software which integrates advanced machine learning methods to automatically detect anomalies. ATTICUS is capable of operating in different application scenarios. Especially, the system will support in-home and out-home monitoring, personal check-ups, and specialized check-ups. Thus, the system will positively impact the canonical medical practices allowing simultaneous and continuous monitoring of a large number of people.

463 The Effect of Intervention of Medical Staff on the Adherence of CPAP and Heart Rate in Patients with Obstructive Sleep Apnea

Introduction Recent studies have indicated that obstructive sleep apnea syndrome (OSAS) is associated with hypertension. OSA is a common cause of sympathetic nervous activity. Increase of sympathetic nervous activity causes hypertension. Continuous positive airway pressure (CPAP) is the most useful treatment for OSAS. Good CPAP adherence treatment improve the risk of hypertension. This study examined the effect of intervention of medical staff on the adherence of CPAP, heart rate and sleep stages in patients with OSA. Methods All patients diagnosed with OSA and undergoing subsequent CPAP were clinically followed for 12 months to examine CPAP adherence, as well as longitudinal changes in blood pressure, average heartrate of 24 hours and sleep stages. They were divided into 2 groups, Group A: patients who had individual consulted in person by sleep physician and technicians before start using CPAP and Group B: patents who did not have individual consulted. Patients in both groups were consulted by sleep physician and technicians after start CPAP with utilizing tele-monitoring. If the adherence were poor, the patients were recommended to stop CPAP. We provided 3D accelerometer and an optical pulse photoplethysmography to all the patients and analyzed the data of heart rate and sleep stages. Results A total of 30 OSA patients underwent CPAP, were enrolled in the study and assessed for changes in mean heart rate and body weight during the study period. We found a significant reduction in mean heart rate in both group A and B compared with baseline (p<-0.05). The patients aged under 50 years old and whose AHI<20 times/hour have higher ratio of dropout CPAP therapy. There was no significant difference between Group A and Group B on the persistency rate of CPAP therapy. Also, no significant association was found between group A and B on the adherence of CPAP. Conclusion We showed the importance of the effect of intervention of medical staff on the adherence of CPAP and heart rate in patients with OSA the consultation after starting CPAP for a while with utilizing tele-monitoring data would be more effective compared with that in person before start using CPAP. Support (if any):

The Evolution of Medicine – Exploring the Contributions of Sony's Technology (Vol. 25, No. 4, Full Issue)

For the month of April 2021, APBN explores the contributions of Sony in the evolution of medicine in our Features section. The article contribution by Leonard Yap, Head of Medical Imaging Solutions, Professional Solutions Company (PSAP) at Sony Electronics Asia Pacific looks at how Sony's technological contributions are revolutionizing the future of medicine. In the Columns section, we discuss the boon and bane of digital technology in healthcare and safety concerns of its use. In the Spotlights, we share about a research done by SingHealth and NUS Yong Loo Lin School of Medicine to determine the receptiveness towards tele-monitoring for the management of chronic health conditions.

Telehealth Strategies to Support Patients and Families Across the Cancer Trajectory

Effective delivery of cancer care via telehealth requires a planned care system that accounts for myriad patient, provider, and practice/cancer center resources before, during, and after the care episode. Telehealth is broadly defined as a method to have virtual, bidirectional communication between patients and providers. Telehealth can include methods such as audio-only, video-consultation, and tele-monitoring, which can occur in a synchronous, asynchronous, or blended format. The purpose of this review is to present common foundational principles for providing clinical cancer care via telehealth, followed by an overview of three distinct examples of comprehensive telehealth programs that have been developed to meet the needs of patients and families across the cancer trajectory, including survivorship, rehabilitation, and palliative care phases. The programs described are exemplars that were developed and implemented prior to the coronavirus pandemic, so they reflect many years of planning and evidence. Lessons learned include the need for ongoing patient support, clinician training, and cancer health system/practice programmatic considerations such as billing, scheduling, reimbursement, software, and hardware/platform security. Although the COVID-19 pandemic produced an explosive shift in regulations and implementation, sustainability of these changes may not be long-term. Nevertheless, a permanent shift in cancer care to include telehealth is likely here to stay.

TECHNICAL SOLUTIONS FOR INDIVIDUAL TELE-MONITORING OF THE FUNCTIONAL STATE OF ORGANISM

We performed analysis of the available Russian home-use health monitoring devices that can be connected to a smartphone or pad for data transfer. Specifically, we sought for the gadgets capable to register heart rate, blood pressure, ECG, blood glucose, and respiration rate. There are three options of data processing and storage. Namely, these are storage in and authorized access to the manufacturer's site with minimal opportunity of data handling and interpretation; an autonomous server to hold and handle big data sets and, finally, access protocols and templates enabling gadget integration with external services.