scholarly journals Mobile app-based Remote Patient Monitoring in Acute Medical Conditions: A Prospective Feasibility Study Exploring Digital Health Solutions on Clinical Workload during the COVID Crisis. (Preprint)

10.2196/23190 ◽  
2020 ◽  
Author(s):  
Sachin Shailendra Shah ◽  
Andrew Gvozdanovic ◽  
Matthew Knight ◽  
Julien Gagnon
Keyword(s):  
Feasibility Study ◽  
Patient Monitoring ◽  
Digital Health ◽  
Mobile App ◽  
Medical Conditions ◽  
Remote Patient Monitoring ◽  
Remote Patient ◽  
Clinical Workload

scholarly journals Mobile app-based Remote Patient Monitoring in Acute Medical Conditions: A Prospective Feasibility Study Exploring Digital Health Solutions on Clinical Workload during the COVID Crisis. (Preprint)

2020 ◽  
Author(s):  
Sachin Shailendra Shah ◽  
Andrew Gvozdanovic ◽  
Matthew Knight ◽  
Julien Gagnon
Keyword(s):  
Feasibility Study ◽  
Patient Monitoring ◽  
Mobile App ◽  
Full Time ◽  
Remote Patient Monitoring ◽  
Phone Calls ◽  
Clinical Scenarios ◽  
Remote Patient ◽  
The Impact ◽  
Clinical Workload

BACKGROUND Digital remote patient monitoring (RPM) can add value to virtual wards; this has become more apparent in the context of the COVID-19 pandemic. Healthcare providers are overwhelmed resulting in clinical teams spread more thinly. We aim to assess the impact of the introduction of an app-based RPM (Huma Therapeutics) on a clinician's workload in the context of a COVID-19 specific virtual ward. OBJECTIVE This prospective feasibility study aims to evaluate the health economic effect (in terms of clinical workload) a mobile app has on a telephone based virtual ward in the monitoring of COVID-19 patients clinically ready for discharge from hospital. METHODS A prospective feasibility study was carried out over one month where clinician workload was monitored, and full time equivalents (FTE) savings equated. An NHS hospital repurposed a telephone-based respiratory virtual ward for COVID-19. Amber status (NHS definition) COVID-19 patients were monitored for 14 days post-discharge to help identify deteriorating patients earlier. A smartphone-based app was introduced to monitor data points submitted by the patients with telephone calls used for communication. A comparison of clinical workload between those monitored by telephone only (Cohort 1) with those monitored via mobile app and telephone (Cohort 2) was undertaken. RESULTS 56 patients were enrolled in the app-based virtual ward (Cohort 2). Digital RPM reduced the number of phone calls from a mean total of 9 to 4 over monitoring period. There was no change in the mean duration of phone calls (8.5minutes), and no reports of readmissions or mortality. This equates to a mean saving of 47.60 working hours. This translates to 3.30 fewer FTEs (raw phone call data), resulting in 1.1 fewer FTEs required to monitor 100 patients when adjusted for time spent reviewing app data. Individual clinicians were averaging 10.9 minutes per day. CONCLUSIONS Smartphone-based RPM technologies may offer tangible reductions in clinician workload at a time of severe service strain. In this small pilot, we demonstrate the economic and operational impact digital RPM technology can have in improving working efficiency and reducing operational costs. Whilst this particular RPM solution was deployed for the COVID-19 pandemic, it may set a precedent for wider utilisation of digital RPM solutions in other clinical scenarios where increased care delivery efficiency is sought. CLINICALTRIAL

scholarly journals Implementation of a mHealth solution to remotely monitor patients on a cardiac surgical waiting list: service evaluation

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Bernard Dillon Obika ◽  
Nikola Dolezova ◽  
Sonia Ponzo ◽  
Sophie Valentine ◽  
Sachin Shah ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Elective Surgery ◽  
Digital Health ◽  
Service Evaluation ◽  
Mobile App ◽  
Waiting List ◽  
Remote Patient Monitoring ◽  
Remote Patient ◽  
Viable Mechanism ◽  
Monitoring Platform

Abstract Background The emergence of COVID-19 resulted in postponement of nonemergent surgical procedures for cardiac patients in London. mHealth represented a potentially viable mechanism for highlighting deteriorating patients on the lengthened cardiac surgical waiting lists. Objective To evaluate the deployment of a digital health solution to support continuous triaging of patients on a cardiac surgical waiting list. Method An NHS trust utilized an app-based mHealth solution (Huma Therapeutics) to help gather vital information on patients awaiting cardiac surgery (valvular and coronary surgery). Patients at a tertiary cardiac center on a waiting list for elective surgery were given the option to be monitored remotely via a mobile app until their date of surgery. Patients were asked to enter their symptoms once a week. The clinical team monitored this information remotely, prompting intervention for those patients who needed it. Results Five hundred and twenty-five patients were on boarded onto the app. Of the 525 patients using the solution, 51 (9.71%) were identified as at risk of deteriorating based on data captured via the remote patient monitoring platform and subsequently escalated to their respective consultant. 81.7% of patients input at least one symptom after they were on boarded on the platform. Discussion Although not a generalizable study, this change in practice clearly demonstrates the feasibility and potential benefit digital remote patient monitoring can have in triaging large surgical wait lists, ensuring those that need care urgently receive it. We recommend further study into the potential beneficial outcomes from preoperative cardiac mHealth solutions.

Proposal for an Implementation Framework for Digital Health Technology in the Intensive Care Unit: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Lina Katharina Mosch ◽  
Akira-Sebastian Poncette ◽  
Claudia Spies ◽  
Steffen Weber-Carstens ◽  
Monique Schieler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Monitoring ◽  
Digital Health ◽  
Implementation Process ◽  
Health Technology ◽  
High Tech ◽  
Remote Patient Monitoring ◽  
Implementation Framework ◽  
Remote Patient

BACKGROUND Despite the vast potential, the digital transformation of intensive care is lagging behind. Comprehensive evidence, along with guidelines for a successful integration of digital health technologies into specific clinical settings such as the intensive care unit (ICU), are scarce—yet essential. OBJECTIVE We evaluated the implementation of a remote patient monitoring platform and derived an implementation framework proposal for digital health technology in an ICU. METHODS We conducted this study from May 2018 to March 2020 during the implementation of a tablet-computer based remote patient monitoring system. The system was installed in the ICU of a large German university hospital as a supplementary monitoring device. Following a hybrid qualitative approach with inductive and deductive elements, we used the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change to analyze the transcripts of seven semi-structured interviews with ICU clinical stakeholders and quantifiable questionnaire data. Results of the qualitative analysis, together with the findings from informal meetings, field observations, and previous explorations, provided the basis for the derivation of the proposed framework. RESULTS Inductive analysis of the interview transcripts revealed an insufficient implementation process because of a lack of staff engagement and little perceived benefits from the novel solution. The ICU was not considered the most suitable for remote patient monitoring, as the staff’s presence and monitoring coverage were high. We propose an implementation framework for digital technologies, including strategies to apply before and during implementation, targeting the implementation setting by involving all stakeholders, assessing the intervention’s adaptability, facilitating the implementation process, and maintaining a vital feedback culture. Setting up a unit responsible for implementation, taking into account the guidance of an implementation advisor, and building on existing institutional capacities could improve the institutional context of implementation projects. CONCLUSIONS The ICU provides an exceptional setting for the introduction of digital health technology because it is a high-tech environment involving multiple professions and high-stress levels. Before implementation, the need for innovation and the ICU’s readiness to change should be assessed. During implementation, a clinical team should ensure transparent communication and continuous feedback. The establishment of an implementation unit is recommended to promote a sustainable implementation culture and to benefit from existing networks. Our proposed framework may guide health providers with concrete, evidence-based, and step-by-step recommendations for implementation practice facilitating the introduction of digital health in intensive care. CLINICALTRIAL ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173

scholarly journals Design Thinking to Create a Remote Patient Monitoring Platform for Older Adults' Homes

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
H. A. Kolnick ◽  
Jennifer Miller ◽  
Olivia Dupree ◽  
Lisa Gualtieri
Keyword(s):  
Older Adults ◽  
Patient Monitoring ◽  
Design Thinking ◽  
Digital Health ◽  
Public Health Practice ◽  
Home Health ◽  
Remote Patient Monitoring ◽  
Thinking Process ◽  
Barriers And Opportunities ◽  
Remote Patient

How might clinicians collect the vitals needed for effective scheduled video visits for older adults? This challenge was presented by AARP to graduate students in a Digital Health course at Tufts University School of Medicine. The design thinking process was used to create a product that would meet this need, keeping the needs and constraints of older adults, especially those with chronic conditions or other barriers to health, central to the solution. The initial steps involved understanding and empathizing with the target audience through interviews and by developing personas and scenarios that identified barriers and opportunities. The later steps were to ideate potential solutions, design a prototype, and define product success. The design thinking process led to the design of Home Health Hub, a remote patient monitoring (RPM) platform designed to meet the unique needs of older adults. Additionally, Home Health Hub can conceivably benefit all users of telehealth, regardless of health status—an important need during the COVID-19 pandemic, and in general due to increased use of virtual visits. Home Health Hub is one example of what can be achieved with the dedicated use of design thinking. The design thinking process can benefit public health practice as a whole by encouraging practitioners to delve into a problem to find the root causes and empathize with the needs and constraints of stakeholders to design innovative, human-centered solutions.

scholarly journals Testing the Feasibility of Remote Patient Monitoring in Prenatal Care Using a Mobile App and Connected Devices: A Prospective Observational Trial

2016 ◽  
Vol 5 (4) ◽  
pp. e200 ◽  
Author(s):  
Kathryn I Marko ◽  
Jill M Krapf ◽  
Andrew C Meltzer ◽  
Julia Oh ◽  
Nihar Ganju ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Patient Monitoring ◽  
Mobile App ◽  
Remote Patient Monitoring ◽  
Observational Trial ◽  
Remote Patient

scholarly journals TMT Interview: Milton Chen, CEO, VSee

2018 ◽  
Vol 2 (5) ◽  
Author(s):  
Milton Chen
Keyword(s):  
Patient Monitoring ◽  
Early Stage ◽  
Digital Health ◽  
Opinion Leaders ◽  
Remote Patient Monitoring ◽  
Term Care ◽  
Patient Deterioration ◽  
Medicine Today ◽  
Remote Patient

No abstract available. Editor’s note:  On March 16th and 17th, 2017, Telehealth and Medicine Today convened a national conference of opinion leaders to discuss and debate “Technologies and Tactics Transforming Long-term Care.” What follows is an interview with Milton Chen, who is who is CEO of VSee, a digital health solution leveraging machine for learning and remote patient monitoring to enable identification of patient deterioration at an early stage.

Remote Patient Monitoring: A Promising Digital Health Frontier

2021 ◽  
Author(s):  
Kimberly Gandy ◽  
Myra Schmaderer ◽  
Anthony Szema ◽  
Chris March ◽  
Mary Topping ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Digital Health ◽  
Remote Patient Monitoring ◽  
Remote Patient

scholarly journals Proposal for an Implementation Framework for Digital Health Technology in the Intensive Care Unit: A Qualitative Study

2020 ◽  
Author(s):  
Lina Mosch* ◽  
Akira-Sebastian Poncette* ◽  
Claudia Spies ◽  
Steffen Weber-Carstens ◽  
Monique Schieler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Monitoring ◽  
Digital Health ◽  
Implementation Process ◽  
Health Technology ◽  
High Tech ◽  
Remote Patient Monitoring ◽  
Implementation Framework ◽  
Remote Patient

Abstract BackgroundIntensive care is lagging with digital transformation. It is essential to provide evidence and guidelines for integrating digital health technologies into the intensive care unit (ICU).We evaluated the implementation of a remote patient monitoring platform and derived an implementation framework proposal for digital health technology in an ICU.MethodsWe conducted this study from May 2018 to March 2020 during the implementation of a tablet-computer based remote patient monitoring system. The system was installed in the ICU of a large German university hospital as a supplementary monitoring device. Following a hybrid qualitative approach with inductive and deductive elements, we used the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change to analyze the transcripts of seven semi-structured interviews with ICU clinical stakeholders and quantifiable questionnaire data. Results of the qualitative analysis, together with the findings from informal meetings, field observations, and previous explorations, provided the basis for the derivation of the proposed framework. Results Inductive analysis of the interview transcripts revealed an insufficient implementation process because of a lack of staff engagement and little perceived benefits from the novel solution. The ICU was not considered the most suitable for remote patient monitoring, as the staff’s presence and monitoring coverage were high. We propose an implementation framework for digital technologies, including strategies to apply before and during implementation, targeting the implementation setting by involving all stakeholders, assessing the intervention’s adaptability, facilitating the implementation process, and maintaining a vital feedback culture. Setting up a unit responsible for implementation, taking into account the guidance of an implementation advisor, and building on existing institutional capacities could improve the institutional context of implementation projects.Conclusions The ICU provides an exceptional setting for the introduction of digital health technology because it is a high-tech environment involving multiple professions and high-stress levels. Before implementation, the need for innovation and the ICU’s readiness to change should be assessed. During implementation, a clinical team should ensure transparent communication and continuous feedback. The establishment of an implementation unit is recommended to promote a sustainable implementation culture and to benefit from existing networks.Trial registrationClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173

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