scholarly journals Impact on Readmission Reduction Among Heart Failure Patients Using Digital Health Monitoring: Feasibility and Adoptability Study (Preprint)

2019 ◽  
Author(s):  
Christopher Park ◽  
Emamuzo Otobo ◽  
Jennifer Ullman ◽  
Jason Rogers ◽  
Farah Fasihuddin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Monitoring ◽  
Remote Monitoring ◽  
Vital Sign ◽  
Readmission Rate ◽  
Health Program ◽  
Digital Health ◽  
Remote Monitoring System ◽  
Mount Sinai ◽  
Heart Health Program

BACKGROUND Heart failure (HF) is a condition that affects approximately 6.2 million people in the United States and has a 5-year mortality rate of approximately 42%. With the prevalence expected to exceed 8 million cases by 2030, projections estimate that total annual HF costs will increase to nearly US $70 billion. Recently, the advent of remote monitoring technology has significantly broadened the scope of the physician’s reach in chronic disease management. OBJECTIVE The goal of our program, named the Heart Health Program, was to examine the feasibility of using digital health monitoring in real-world home settings, ascertain patient adoption, and evaluate impact on 30-day readmission rate. METHODS A digital medicine software platform developed at Mount Sinai Health System, called RxUniverse, was used to prescribe a digital care pathway including the HealthPROMISE digital therapeutic and iHealth mobile apps to patients’ personal smartphones. Vital sign data, including blood pressure (BP) and weight, were collected through an ambulatory remote monitoring system that comprised a mobile app and complementary consumer-grade Bluetooth-connected smart devices (BP cuff and digital scale) that send data to the provider care teams. Care teams were alerted via a Web-based dashboard of abnormal patient BP and weight change readings, and further action was taken at the clinicians’ discretion. We used statistical analyses to determine risk factors associated with 30-day all-cause readmission. RESULTS Overall, the Heart Health Program included 58 patients admitted to the Mount Sinai Hospital for HF. The 30-day hospital readmission rate was 10% (6/58), compared with the national readmission rates of approximately 25% and the Mount Sinai Hospital’s average of approximately 23%. Single marital status (<italic>P</italic>=.06) and history of percutaneous coronary intervention (<italic>P</italic>=.08) were associated with readmission. Readmitted patients were also less likely to have been previously prescribed angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (<italic>P</italic>=.02). Notably, readmitted patients utilized the BP and weight monitors less than nonreadmitted patients, and patients aged younger than 70 years used the monitors more frequently on average than those aged over 70 years, though these trends did not reach statistical significance. The percentage of the 58 patients using the monitors at least once dropped from 83% (42/58) in the first week after discharge to 46% (23/58) in the fourth week. CONCLUSIONS Given the increasing burden of HF, there is a need for an effective and sustainable remote monitoring system for HF patients following hospital discharge. We identified clinical and social factors as well as remote monitoring usage trends that identify targetable patient populations that could benefit most from integration of daily remote monitoring. In addition, we demonstrated that interventions driven by real-time vital sign data may greatly aid in reducing hospital readmissions and costs while improving patient outcomes.

scholarly journals Impact on Readmission Reduction Among Heart Failure Patients Using Digital Health Monitoring: Feasibility and Adoptability Study

10.2196/13353 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e13353 ◽  
Author(s):  
Christopher Park ◽  
Emamuzo Otobo ◽  
Jennifer Ullman ◽  
Jason Rogers ◽  
Farah Fasihuddin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Monitoring ◽  
Remote Monitoring ◽  
Vital Sign ◽  
Readmission Rate ◽  
Health Program ◽  
Digital Health ◽  
Remote Monitoring System ◽  
Mount Sinai ◽  
Heart Health Program

Background Heart failure (HF) is a condition that affects approximately 6.2 million people in the United States and has a 5-year mortality rate of approximately 42%. With the prevalence expected to exceed 8 million cases by 2030, projections estimate that total annual HF costs will increase to nearly US $70 billion. Recently, the advent of remote monitoring technology has significantly broadened the scope of the physician’s reach in chronic disease management. Objective The goal of our program, named the Heart Health Program, was to examine the feasibility of using digital health monitoring in real-world home settings, ascertain patient adoption, and evaluate impact on 30-day readmission rate. Methods A digital medicine software platform developed at Mount Sinai Health System, called RxUniverse, was used to prescribe a digital care pathway including the HealthPROMISE digital therapeutic and iHealth mobile apps to patients’ personal smartphones. Vital sign data, including blood pressure (BP) and weight, were collected through an ambulatory remote monitoring system that comprised a mobile app and complementary consumer-grade Bluetooth-connected smart devices (BP cuff and digital scale) that send data to the provider care teams. Care teams were alerted via a Web-based dashboard of abnormal patient BP and weight change readings, and further action was taken at the clinicians’ discretion. We used statistical analyses to determine risk factors associated with 30-day all-cause readmission. Results Overall, the Heart Health Program included 58 patients admitted to the Mount Sinai Hospital for HF. The 30-day hospital readmission rate was 10% (6/58), compared with the national readmission rates of approximately 25% and the Mount Sinai Hospital’s average of approximately 23%. Single marital status (P=.06) and history of percutaneous coronary intervention (P=.08) were associated with readmission. Readmitted patients were also less likely to have been previously prescribed angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (P=.02). Notably, readmitted patients utilized the BP and weight monitors less than nonreadmitted patients, and patients aged younger than 70 years used the monitors more frequently on average than those aged over 70 years, though these trends did not reach statistical significance. The percentage of the 58 patients using the monitors at least once dropped from 83% (42/58) in the first week after discharge to 46% (23/58) in the fourth week. Conclusions Given the increasing burden of HF, there is a need for an effective and sustainable remote monitoring system for HF patients following hospital discharge. We identified clinical and social factors as well as remote monitoring usage trends that identify targetable patient populations that could benefit most from integration of daily remote monitoring. In addition, we demonstrated that interventions driven by real-time vital sign data may greatly aid in reducing hospital readmissions and costs while improving patient outcomes.

Abstract 18895: Utility of Remote Monitoring Using a Mobile Phone in Patients with Heart Failure: the REMOTE-HF-1 Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Marcus Stahlberg ◽  
Satish C Govind ◽  
Nicole M Orr ◽  
Aasha S Gopal ◽  
Justine S Lachmann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Mobile Phone ◽  
Monitoring System ◽  
Primary Endpoint ◽  
Remote Monitoring ◽  
Nyha Class ◽  
Drop Out ◽  
Remote Monitoring System ◽  
Custom Made

Objective: To investigate the clinical feasibility (technical feasibility and patient-/clinician adherence) of remote telemonitoring, using a mobile phone, in an international and diverse HF population. Methods: HF patients from five centers in the USA, India and Sweden were equipped with a blood pressure apparatus, digital weight scale and a mobile phone device with custom made software for remote telemonitoring (Vitalbeat®). Patients were asked to record and transmit daily information on body weight, blood pressure and pulse rate as well as symptoms and adherence to medical therapy for 90 days. The primary endpoint, for assessment of general feasibility was defined as % of days with a combination of successful data transmission from patients and data read by clinicians. Acceptable clinical feasibility was a priori set as ≥ 66% of days meeting the primary endpoint. A survey was used to assess patients’ opinions about the remote monitoring system. Data was analyzed according to Intention to treat. Results: 46 HF patients were included (India=20, USA=13, Sweden=13; 59±16yrs; 84% male; NYHA-class 2.4±0.8) and followed for a total of 4410 days. The primary endpoint occurred in 3178 days (77%) and 34/46 patients (74%) exceeded the cut-off ≥ 66% of days meeting endpoint criteria. In the majority of patients (n=28; 61 %) the primary endpoint was met ≥ 90% of the days, and in 6 patients (13%) 66-89% of the days.Twelve patients (26%) opted to drop out of the study prematurely or were hospitalized for HF related causes. Compared to patients with acceptable clinical feasibility (≥ 66%), patients with less than acceptable feasibility (< 66%) were older (72±12 vs. 56±15 yrs, p=0.003) and more likely to be followed at a center in USA or Sweden (p=0.02 vs. Indian centers). The monitoring system was described as user friendly by 91 % of patients. Conclusion: This study shows that remote telemonitoring using a mobile phone is clinically feasible in an international and diverse heart failure population. However, monitoring was less feasible in elderly patients and depended on the geographic location. Further studies are warranted to assess whether clinical feasibility can improve with improved software/hardware design and/or patient selection.

scholarly journals Use of Remote Monitoring to Improve Outcomes in Patients with Heart Failure: A Pilot Trial

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Ambar Kulshreshtha ◽  
Joseph C. Kvedar ◽  
Abhinav Goyal ◽  
Elkan F. Halpern ◽  
Alice J. Watson
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Readmission Rate ◽  
Hospital Admissions ◽  
Massachusetts General Hospital ◽  
Pilot Trial ◽  
Ambulatory Setting ◽  
Care Group ◽  
Control Group ◽  
Coordinated Care

Remote monitoring (RM) of homebound heart failure (HF) patients has previously been shown to reduce hospital admissions. We conducted a pilot trial of ambulatory, non-homebound patients recently hospitalized for HF to determine whether RM could be successfully implemented in the ambulatory setting. Eligible patients from Massachusetts General Hospital () were randomized to a control group () or to a group that was offered RM (). The participants transmitted vital signs data to a nurse who coordinated care with the physician over the course of the 6-month study. Participants in the RM program had a lower all-cause per person readmission rate (, ) compared to the usual care group (, ; ) although the difference was not statistically significant. HF-related readmission rate was similarly reduced in participants. This pilot study demonstrates that RM can be successfully implemented in non-homebound HF patients and may reduce readmission rates.

Safety Evaluation of an Automated Remote Monitoring System for Heart Failure in an Urban, Indigent Population

2017 ◽  
Vol 20 (6) ◽  
pp. 449-457 ◽  
Author(s):  
Sandra Gross-Schulman ◽  
Laura Myerchin Sklaroff ◽  
Crystal Coyazo Hertz ◽  
Jeffrey J. Guterman
Keyword(s):  
Heart Failure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Safety Evaluation ◽  
Remote Monitoring System ◽  
Indigent Population

Expectations for the Remote Monitoring System in Heart Failure Patients with CRT

2013 ◽  
Vol 19 (10) ◽  
pp. S118
Author(s):  
Makoto Suzuki ◽  
Yuya Matsue ◽  
Rena Nakamura ◽  
Maki Ono ◽  
Ryota Iwatsuka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Remote Monitoring System ◽  
Heart Failure Patients

scholarly journals First experience with a ready-to-use solution for remote monitoring of patients suffering from heart failure

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Lemieux ◽  
F Picard ◽  
F Barritault ◽  
J Labarre ◽  
S Lafitte ◽  
...  
Keyword(s):  
Heart Failure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Web Application ◽  
Patient Management ◽  
Remote Monitoring System ◽  
Funding Sources ◽  
Current Period ◽  
Potential Benefits

Abstract Funding Acknowledgements Type of funding sources: None. Background Heart failure (HF) is associated with a high mortality rate and recurrent hospitalizations. Purpose To present the first data of the patients using Satelia® Cardio solution Method Satelia® Cardio is a HF patient management solution with a remote monitoring system and a therapeutic guidance by a dedicated-nurse phone platform, supported by the ETAPES Program. The system is accessible from any device and requiring no installation. After the inclusion, the patient is contacted by the nurse, he then receives an SMS alerts following cardiologist prescription (on regular basis), with a link leading to a web page on which he will answer 7 questions and enter his current body weight. Satelia® Cardio algorithm is based on these data inputs, their variability, and the weight. In case of worsening of symptoms, the cardiologist will be notified. Since Covid-19 lockdown, more than 1400 patients have been monitored with the solution. Results 165 centers (306 cardiologists) are using Satelia® Cardio with 3540 HF patients monitored in the last 29 months. The patients with a mean age of 72 years (19-100) are predominantly males (67%), and mostly NYHA II/III (69%/31%) with a mean LVEF of 40%. The adherence to the system is very good (91%) with 78% of patients still monitored (n = 2787). The main reasons for stopping are related to the occurrence of death (205/753) or patient/HCP decision (392/753), or other reasons (156/753). Over the period of analysis, the HF patients answered to 163 700 questionnaires, generating 8210 alerts transmitted to the referent cardiologists. Conclusion Patient management solution with a remote monitoring system is key to improving the follow-up of HF patients. The solution Satelia® Cardio is an easy way to use a web application to monitor HF patients, especially on the current period of Covid-19 with a low rate of premature discontinuation. A further step will be to initiate studies to assess the potential benefits for both patients and HCPs  of such remote monitoring solution in HF.

scholarly journals Digital Health: Implications for Heart Failure Management

2021 ◽  
Vol 7 ◽  
Author(s):  
Arvind Singhal ◽  
Martin R Cowie
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Digital Health ◽  
Information And Communications Technology ◽  
Heart Failure Management ◽  
Heart Failure Patients ◽  
Data Validity ◽  
Multiparameter Monitoring ◽  
Advanced Computing ◽  
Clinical Stability

Digital health encompasses the use of information and communications technology and the use of advanced computing sciences in healthcare. This review covers the application of digital health in heart failure patients, focusing on teleconsultation, remote monitoring and apps and wearables, looking at how these technologies can be used to support care and improve outcomes. Interest in and use of these technologies, particularly teleconsultation, have been accelerated by the coronavirus disease 2019 pandemic. Remote monitoring of heart failure patients, to identify those patients at high risk of hospitalisation and to support clinical stability, has been studied with mixed results. Remote monitoring of pulmonary artery pressure has a consistent effect on reducing hospitalisation rates for patients with moderately severe symptoms and multiparameter monitoring shows promise for the future. Wearable devices and apps are increasingly used by patients for health and lifestyle support. Some wearable technologies have shown promise in AF detection, and others may be useful in supporting self-care and guiding prognosis, but more evidence is required to guide their optimal use. Support for patients and clinicians wishing to use these technologies is important, along with consideration of data validity and privacy and appropriate recording of decision-making.

Smart-band BPM and Temperature Based on Android Using Wi-Fi Communication

2021 ◽  
Vol 14 (2) ◽  
pp. 62-67
Author(s):  
Pandu Arsy Filonanda ◽  
I DEWA GEDE HARI WISANA ◽  
PRIYAMBADA CAHYA NUGRAHA
Keyword(s):  
Real Time ◽  
Mobile Phones ◽  
Health Monitoring ◽  
Remote Monitoring ◽  
Home Monitoring ◽  
Monitoring Device ◽  
Digital Output ◽  
Remote Monitoring System ◽  
Small Frame ◽  
Monitoring Devices

Monitoring of patients is an integral part of  health-care system, both in the hospital and at home. Monitoring devices are useful to monitor a person's health. Monitoring is necessary in case of symptoms of a disease that must be acted quickly to prevent the patient's condition from worsening. One way of monitoring patients' specifications is shown by their BPM value and temperature. The purpose of this study is the design of devices on a patient's wrist that can monitor BPM and his body temperature in real time and are not affected by distance. This research contribution is a system that can provide bradycardia indicators and tachycardia for BPM while hyperthermia and hypothermia for temperature. For a monitoring device to be more practical and efficient for use, it has a device with real time monitoring and a small frame of bracelets and alerts phones and emails during abnormal conditions. The design of the device uses the SEN0203  sensors as a BPM sensor that has analog and digital outputs, as well as  MLX90614  sensors that have a digital output, and then data will be processed and shown live to oled ESP333TTGO and data sent to the blynk application on the phone aided by ESP32TTGO as a wifi module. The BPM has the smallest 0.1% error and the largest of 1.09% whereas the temperature has the smallest 0.19% and the largest of 1.63%. These results can be redeveloped on monitor patients to increase the efficiency of the remote monitoring system with alert conditions of patients at an abnormal time via mobile phones and emails.

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