Innovative telemonitoring system for cardiology: from science to routine operation.
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Date
2013-04-25
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Abstract
OBJECTIVE 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
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At risk for a particular disease or infection, Facility-based health worker, Access to information or data, Continuity of care, Unnecessary referrals and transportation, Quality of care, Pilot, Cardiovascular disease, Non-communicable diseases, Chronic care, Disease management, Surveillance, Data collection and reporting, Physiologic Biosensors