Home Remote Monitoring System Research Articles

An early screening model of pulse detection technology for hepatic steatosis

BackgroundThe increasing prevalence of hepatic steatosis presents a considerable challenge to public health. There is a critical need for the development of novel preventive and screening strategies for this condition. This study evaluated the potential applications of wrist pulse detection technology for the early detection of liver diseases. The pulse time-domain features of a medical exam population with and without hepatic steatosis were assessed to develop a screening model for this disease. MethodsParticipants were consecutively recruited from March 2021 to March 2022 in the medical examination centers of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine and the Shanghai Municipal Hospital of Traditional Chinese Medicine. Clinical data from 255 participants, including general information (sex, age, and body mass index), and data related to glucose and blood lipids (fasting plasma glucose, triglyceride, total cholesterol, high-density lipoprotein, and low-density lipoprotein levels) were collected. Wrist pulse signals were acquired using a pulse detection device, and the pulse time-domain features, including t1, t4, t5, T, w1, w2, h2/h1, h3/h1, and h5/h1 were extracted. Participants were assigned to hepatic steatosis and non-hepatic steatosis groups according to their abdominal ultrasound examination results. Their clinical data and pulse time-domain features were compared using chi-square and parametric or non-parametric statistical methods. Three datasets were used to construct screening models for hepatic steatosis based on the random forest algorithm. The datasets for modeling were defined as Dataset 1, containing blood glucose and lipid data and general information; Dataset 2, containing time-domain features and general information; Dataset 3, containing time-domain features, blood glucose and lipid data, and general information. The evaluation metrics, accuracy, precision, recall, F1-score, and areas under the receiver operating characteristic curve (AUC) were compared for each model. ResultsThe time-domain features of the two groups differed significantly. The t1, t4, t5, T, h2/h1, h3/h1, w1, and w2 features were higher in the hepatic steatosis group than in the non-hepatic steatosis group (P < 0.05), while the h5/h1 features were lower in the hepatic steatosis group than in the non-hepatic steatosis group (P < 0.05). The screening models for hepatic steatosis based on both time-domain features and blood glucose and lipid data outperformed those based on time-domain features or blood markers alone. The accuracy, precision, recall, F1-score, and AUC of the combined model were 81.18%, 80.56%, 76.32%, 79%, and 87.79%, respectively. These proportions were 1.57%, 1.86%, 1.76%, 2%, and 3.54% higher, respectively, than those of the model based on time-domain features alone and 3.14%, 4.2%, 2.64%, 4%, and 6.47% higher, respectively, than those of the model based on blood glucose and lipid alone. ConclusionThe early screening model for hepatic steatosis using datasets that included pulse time-domain features achieved better performance. The findings suggest that pulse detection technology could be used to inform the development of a mobile medical device or remote home monitoring system to test for hepatitis steatosis.

Comprehensive telemedicine solution for remote monitoring of Parkinson’s disease patients with orthostatic hypotension during COVID-19 pandemic

ObjectiveOrthostatic hypotension (OH) represents a frequent but under-recognized phenomenon in Parkinson’s disease (PD). During COVID-19 pandemic, Information and Communication Technologies (ICT) have become pivotal in the management of chronic diseases like PD, not only to assess motor impairment, but also for vital signs monitoring. This pilot study aimed to propose a real-time remote home-monitoring system and protocol for PD patients with OH.MethodsVital parameters were acquired by wireless devices and transmitted to an ICT platform, providing data and smart notifications to the healthcare provider through an interactive web portal. Eight patients with idiopathic PD and OH underwent 5-day monitoring. Data about OH episodes, therapeutic interventions, impact on daily activities, and patient satisfaction were collected and analyzed.ResultsThe proposed solution allowed the identification of 65 OH episodes and subsequent medical interventions. Thirty-five episodes were asymptomatic, especially in the postprandial and in the afternoon recordings. Systolic-blood-pressure (SBP) and diastolic-blood-pressure (DBP) were significantly lower in symptomatic episodes, while the pressure drops resulted significantly higher in presence of symptoms. High usability and patient satisfaction scores were observed.ConclusionThe proposed home-monitoring system and protocol have proved to provide useful information and to allow prompt interventions in the management of PD patients with OH during COVID-19 pandemic.

Treatment of Cryptogenic Stroke Patients with Atrial Fibrillation Detected by Insertable Cardiac Monitors Reduces Recurrent Stroke Risk to Background Levels.

Atrial fibrillation (AF) is a known risk factor of ischemic stroke with a reported fivefold increase in incidence. However, it is not well established whether treatment with oral anticoagulation (OAC) in cryptogenic stroke patients with AF, detected by insertable cardiac monitors (ICMs), reduces the risk of recurrent stroke. We aimed to compare recurrent stroke rates between cryptogenic stroke patients who have AF detected by ICMs and thus started on OAC treatment and those without detected AF. We performed a combined retrospective and prospective analysis of consecutive patients who received an ICM indicated for cryptogenic stroke and were followed up with between July 2015 and November 2019. Patients with a prior documented history of AF were excluded. All patients were required to have a home remote monitoring system. We calculated the rates of AF detection and OAC initiation, then compared recurrent annualized stroke rates (ASRs) between patients with and without AF detected. A total of 298 patients with ICMs were included in the study [mean ± standard deviation age: 77 ± 11.7 years; female/male: 147/151; virtual CHA2DS2-VASc score: 4.96 ± 1.28 points]. AF was discovered in 91 patients (~30%) over a mean 19.3 months follow-up. Of those, 65 (71.4%) were started on OAC, 12 (13.2%) were already on OAC, and 10 (11%) remained non-anticoagulated. In four (4.4%) patients, OAC was started after recurrent stroke when AF was diagnosed. A total of 24 of 298 patients developed recurrent strokes (ASR: 5.0%). Among the 24 patients with recurrent strokes, four had new AF and were on OAC (ASR: 3.23%), six had new AF and were not anticoagulated (ASR: 26.62%), and 14 had no AF detected and no OAC (ASR: 4.20%). Our study found new AF detected by ICMs in almost one-third (30%) of cryptogenic stroke patients (consistent with previous studies), and the majority of them (89%) received OACs. There was no significant difference in the recurrent stroke rate among patients without AF detected and those with AF detected and on OAC. Rigorous arrhythmia monitoring using ICMs can increase new AF detection rates in cryptogenic stroke patients, thereby allowing early initiation of OACs, ultimately reducing the risk of recurrent stroke to background levels.

Abstract WMP62: Remote Home Monitoring of Risk Factors After Stroke or TIA to Improve Secondary Prevention - A Pilot Study

Background: Up to 90% of strokes could be prevented by effective treatment of the risk factors. However, there are major problems with the implementation of prevention. For example, only 40% of patients taking medication have blood pressure (BP) at treatment goals and 60% of patients with atrial fibrillation (AF) use anti-coagulant medication. Hypothesis: Remote home monitoring of risk factors after minor stroke or TIA may lead to better control of risk factors by increasing measurements and patient awareness and uncovering undetected risk factors. This pilot study investigates the feasibility of home monitoring of risk factors after minor stroke or TIA. Methods and Patients: Patients (n=30, mean age 57 yrs, range 34-79, 37% females) with recent minor stroke or TIA were supplied with a remote home monitoring system at discharge. The system comprised of a cloud backend for data storage and processing, patient user interface (UI), and wireless BP meter and light-weight EKG device with secured connection to clinician UI, through which BP and EKG could be followed real-time and individualized alarm limits could be set. EKG was automatically analyzed in the cloud backend to detect AF. The patients were contacted by phone at two weeks by stroke nurse and they returned the remote home monitoring system at final visit at three months. Additionally they were contacted if AF was detected or their BP required medication adjustment. Results: Twenty-nine (97%) patients completed the study. One patient discontinued due to unrelated serious illness. One patient did not follow the monitoring program. Of the remaining 28 patients (93%) with complete monitoring data, BP medication needed adjustment in 11 patients (39%) and new AF was detected in 3 patients (11%). Patients appraised that the home monitoring system was easy to use (score 8.6/10) and most would recommend it to peers (score 8.9/10). Conclusions: Remote home monitoring of risk factors after minor stroke or TIA is feasible and may be an efficient way to improve secondary prevention.

Intelligent Home Monitoring System Based on Internet of Things

To realize the remote monitoring and intelligent management of the home environment, intelligent home remote monitoring system is developed based on the Internet of things technology. By using RF transceiver chip and GPRS technology, a smart home system scheme for wireless networks is established. The hardware and software design of sensor nodes and GPRS wireless communication base station is completed. Sensor nodes are used to monitor the acquisition of field data. Based on GPRS technology, the wireless communication base station realizes the uploading of monitoring data. The wireless communication between the node and the base station is realized by radio frequency transceiver chip SI4432. The results show that the system reaches the aim of expected design function. Therefore, it can be concluded that the system can meet the intelligent monitoring of the home environment.

Design of Electronic Remote Control System Based on Wireless Sensor

A wireless remote sensing system based on wireless sensor network solution is proposed, to achieve the remote control of home appliances. The remote control system uses STM32F103 chip as the main controller of the smart home system, and applies the CC1110 radio frequency module as the communication node of the home wireless sensor network. Through the Simplici TI network protocol, these nodes together are put forward to form a small home LAN. Then, combining with GPRS wireless communication technology and Web Internet technology, these nodes to the remote server are collected. The results showed that through the user's mobile terminal access, it can form a wireless remote monitoring system. The conclusion is drawn that an intelligent home remote monitoring system based on wireless sensor network is feasible and it has good performances.

Experiences of applying home monitoring for cardiac implantable electronic devices

To observe the results of remote home monitoring for cardiac implantable electronic devices (CIED). From November 2009 to July 2014, 37 patients implanted with home monitoring system CIED were enrolled, and 31 cases were implanted with dual chamber pacemakers, 2 with cardiac resynchronization therapy(CRT) and 4 with implantable cardioverter defibrillator (ICD). All patients received clinical routine follow-up.Data was automatic transmitted daily by remote home monitoring system, while special alarm events were transmitted at any time.The success rate of data transmission, abnormal events monitoring and pacing parameter changes were analyzed. A total of 37 patients (24 males, mean age (70.0±9.6) years) were enrolled.Average follow-up time was (902±404) days.Success rate of data transmission was 97.6% (32 574), failed data transmission rate was 2.4% (801). Ninth-nine alerts were transmitted from 28 patients (75.7%), including 80 (80.8%) disease-related alerts and 19 (19.2%) system-related alerts.Average detection time of atrial fibrillation by remote home monitoring system to last clinical routine follow-up was 62 (19-120) days.There was no significant change in ventricular threshold, atrial and ventricle sensing during acute, subacute and chronic phases post the application of the steroid-eluting leads(all P>0.05). The success rate of data transmission for CIED with remote home monitoring system is efficient, abnormal events can be timely detected.Meanwhile, remote home monitoring system also verified the stability of pacing parameters during acute, subacute and chronic phases post the application of the steroid-eluting leads.

Design and Realization of Home Remote Monitoring System Based on Android Client

Design and Realization of Home Remote Monitoring System Based on Android Client

Assessment of Outpatients’ Waiting Time and the Intervals to Find out Arrhythmic Events or Abnormal Device Performance Using Remote Home Monitoring System

Assessment of Outpatients’ Waiting Time and the Intervals to Find out Arrhythmic Events or Abnormal Device Performance Using Remote Home Monitoring System

Intrathoracic Fluid Monitoring System (OptiVol) Proved Useful for Earlier Detection of Heart Failure (HF) and Asymptomatic Electrical Storm of Slow VT: A Case Report

We report a case of 78-year-old man with dilated form of hypertrophic cardiomyopathy. An ICD (Secura, Medtronic Inc.) was implanted for drug-resistant ventricular tachycardia (VT). He received remote home monitoring system (CareLink) including intrathoracic fluid monitoring system (OptiVol). On December 9, 2010, he suffered from general fatigue, but did not have any symptom due to VT. At midnight on December 15, the OptiVol alert due to severe increase of OptiVol fluid index was automatically transmitted. On the next day, we received the alert. In the transmitted data, we found that 85 episodes of sustained VT (mean HR 143 bpm) had occurred and antitachycardia pacing (ATP) was performed 243 times for the VT since December 9. He was diagnosed as HF due to electrical storm of slow VT and admitted emergently on the same day. He received medical treatment for HF and VT. Eventually, he underwent RFCA for VT because of resistance to medication. Finally, we succeeded in terminating the VT by RFCA and improving HF. He had asymptomatic electrical storm of VT, which developed into HF. In this case, the OptiVol alert provided the earlier detection of HF and consequently gave a chance to find out the asymptomatic electrical storm of slow VT resistant to repeated ATP.

Automatic remote home monitoring is a safe option for ICD follow-up

Patients with an implantable cardioverter-defibrillator (ICD) require follow-up to monitor their clinical status and device function. Remote home monitoring has the potential to reduce costs and workload while providing continuous ICD surveillance. In the TRUST study, the safety and utility of an automatic remote home monitoring system were compared with conventional follow-up for patients with an ICD. “The automatic home monitoring system ... detects potential events at the earliest possible stage and automatically informs the patient's physician,” explains investigator Niraj Varma from the Cleveland Clinic, OH, USA.

AT EASE: Automated Technology for Elder Assessment, Safety, and Environmental monitoring

Background : Independent Living Residences (ILRs) for elders are becoming a popular and less expensive option than assisted living facilities. ILRs, however, operate with minimal professional staffing and new ways are needed to provide oversight of increasingly frail and/or confused elders who live alone. Objective : To gain an understanding of the elders, families and staff concerns in ILRs and to investigate whether remote residential monitoring, using off-the-shelf wireless sensors, might address these concerns. Methods : Mixed methods approach. Phase 1 qualitative research involved eight sets of focus groups comprised of either elderly residents from ILRs, relatives of residents, building managers and superintendents, or affiliated nurse practitioners (NPs) providing residential services. Phase 2 implementation built the system in response to end users input. Detailed testing of signal reliability and validity occurred. Phase 3 involved an 18 month implementation period with 10 sets of end users using the system for at least 4 months each. End user sets –residents, family members, building staff and nurse practitioners were assessed pre and post implementations. Results : Across the end user subgroups concerns varied but they all shared in common worries about the safety and well-being of the residents. Specific memory related issues included medications, meals, and shutting off the toilet/bath water. The Automated Technology for Elder Assessment, Safety and Environment (AT EASE) remote home monitoring system was developed to uniquely tailor the type of sensor and activities monitored to the individual’s particular concern(s). Initial reliability trials uncovered severe signal interference for the X10 based wireless sensor system. This resulted in a redesign and successful deployment of a Zigbee based system. Moreover for the first time alert information was triaged to multiple parties, authorized as recipients, and occurred without any data security breaches. For example, only the building superintendent would receive the toilet overflow alert, the family member the missed meal or medication alert and the nurse practitioner when several medications were missed. Conclusions : Multiple safety and well being concerns arose that could be addressed through sensor based residential monitoring but most residents underestimated their personal vulnerability. Key to acceptance was the residents' perceived need and usefulness of the system to maintain independence and prevent being relocated to a more restrictive environment. Families found the system easy to use and were very satisfied. Building staff highly valued the water overflow alerts and having an additional means to oversee residents’ safety that did not increase their workload. NPs were non-adopters (feared information overload) favoring personal interaction with residents to medication compliance monitoring. End users favored passive alert notices, (over proactively monitoring the website site for residents’ status) that were few in number, and valid. They did not want to monitor the monitoring data and believed that accurate alerting was critical and achieved.

The development and impact on business of the world's first live video streaming distribution platform for 3G mobile videophone terminals

We have developed the world's first live video distribution platform capable of simultaneously delivering live video to multiple mobile phones, e.g. mobile videophone terminals and PDAs (Personal Digital Assistants), as a 3rd-generation (3G) mobile communications service. Although we are already providing a one-to-one moving picture delivery (videophone) service as a 3G mobile phone service, we did not yet have a one-to-many system of delivering live video to multiple terminals. The new platform delivers video to terminals using the bearer of a 3G-324M line provided with 3G mobile communications servics. The same content can be delivered simultaneously in a maximum of 500 streams to mobile phones with a video delay of approximately 7 seconds, a picture size of 176 x 144 pixels, and a frame rate of 10 fps. This paper also summarises the possibilities of using this platform to create business models that use a mobile videophone to provide a child care centre monitoring system, a home remote monitoring system, or other systems that were not possible with existing mobile phones.