Browsing by Author "Morak, J"
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- ItemInnovative telemonitoring system for cardiology: from science to routine operation.(2013-04-25) Kastner, P; Morak, J; Modre, R; Kollmann, A; Ebner, C; Fruhwald, Fm; Schreier, GOBJECTIVE Results of the Austrian MOBITEL MOBIle phone based TELemonitoring for heart failure patients trial indicate that home based telemonitoring improves outcome of chronic heart failure CHF patients and reduces both frequency and duration of hospitalizations Based on lessons learned we assessed the weak points to clear the way for routine operations METHODS We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements The following components have been identified a patient terminal with highest usability integrated way to document drug intake and well being and automated event detection for worsening of CHF As a consequence the system was extended by Near Field Communication NFC technology and by an event management tool RESULTS Usability evaluation with 30 adults 14f median 51y IQR 45 65 showed that 21 8f were able to immediately operate the system after reading a step by step manual Eight 6f needed one time demonstration and one man 80y failed to operate the blood pressure meter Routine operation of the revised system started in March 2009 Within 9 months 15 patients 4f median 74y IQR 71 83 all NYHA III transmitted 17 149 items 43 events were detected because of body weight gain of more then 2kg within 2 days 49 therapy adjustments were documented Three patients stopped using the system two 1f because of non compliance and one m 82y because of death Overall the rate of adherence to daily data transfer was 78 CONCLUSION First results confirm the applicability of the revised telemonitoring system in routine operation
- ItemNear Field Communication-based telemonitoring with integrated ECG recordings.(2013-04-25) Morak, J; Kumpusch, H; Hayn, D; Leitner, M; Scherr, D; Fruhwald, F M; Schreier, GOBJECTIVES Telemonitoring of vital signs is an established option in treatment of patients with chronic heart failure CHF In order to allow for early detection of atrial fibrillation AF which is highly prevalent in the CHF population telemonitoring programs should include electrocardiogram ECG signals It was therefore the aim to extend our current home monitoring system based on mobile phones and Near Field Communication technology NFC to enable patients acquiring their ECG signals autonomously in an easy to use way METHODS We prototypically developed a sensing device for the concurrent acquisition of blood pressure and ECG signals The design of the device equipped with NFC technology and Bluetooth allowed for intuitive interaction with a mobile phone based patient terminal This ECG monitoring system was evaluated in the course of a clinical pilot trial to assess the system s technical feasibility usability and patient s adherence to twice daily usage RESULTS 21 patients 4f 54 14 years suffering from CHF were included in the study and were asked to transmit two ECG recordings per day via the telemonitoring system autonomously over a monitoring period of seven days One patient dropped out from the study 211 data sets were transmitted over a cumulative monitoring period of 140 days overall adherence rate 82 2 55 and 8 of the transmitted ECG signals were sufficient for ventricular and atrial rhythm assessment respectively CONCLUSIONS Although ECG signal quality has to be improved for better AF detection the developed communication design of joining Bluetooth and NFC technology in our telemonitoring system allows for ambulatory ECG acquisition with high adherence rates and system usability in heart failure patients