Remote Monitoring Devices Research Articles

Indigenous and Disruptive Remote Patient Monitoring Devices - A Case Study on AI in Healthcare

The evolution of Industry 4.0 technologies has facilitated the growth of technologically driven healthcare solutions, disrupting, and significantly challenging the way the sector works and moving towards Healthcare 4.0. The global interest in Artificial Intelligence (AI) in the healthcare sector is increasing tremendously in comparison to other sectors. A rapidly ageing population with increasing health complications has led to the rise of AI-driven Remote Patient Monitoring (RPM) devices, where a patient can be monitored in the comfort of a home, using the latest communication and sensor technologies. This study aims to understand the usage of Artificial Intelligence (AI) as a healthcare disruptor, capturing the ever-increasing demands concerning the remote patient monitoring industry, making huge improvements, and redefining the way how healthcare can be provided, for timely and cost-effective solutions. The analysis of these remote monitoring devices has been done through a case study approach. For this purpose, two AI-enabled remote patient monitoring devices Dozee.ai and Qure.ai, have been taken which have been assisting patients and doctors in the diagnosis of health vitals remotely. Data has been taken from secondary sources to analyze the concept of indigenous and disruptive innovations. Both the apps have been quite successful in their diagnosis of Covid positive patients and have assisted both patients and healthcare personnel during critical times. Despite the huge advantages of AI-enabled RPM devices, they are vulnerable to data hacking and privacy issues. Any errors in these devices can pose potential risks to patients’ health.

The Virtual Visit: A Telehealth Curriculum for Internal Medicine Residents Featuring a Virtual Physical Examination.

During the COVID-19 pandemic, medical professionals were obligated to adapt to virtual care. Most resident physicians had no formal telehealth training. The virtual physical examination remained underutilized. We describe a needs assessment leading to the creation of a telehealth curriculum for internal medicine (IM) and internal medicine pediatric (IM/P) residents, and report changes in residents' confidence level as well as feasibility data. We hypothesized that residents' confidence in delivering virtual care would significantly improve after implementing a telehealth curriculum. A needs-based assessment for all University of California Los Angeles (UCLA) IM and IM/P residents was conducted in July 2020. Specific competencies were identified: (1) telehealth legal guidelines; (2) virtual physical examination; (3) health equity; and (4) telehealth chronic disease management. The curriculum was presented via 3 synchronous interactive online interventions between November 2020 and March 2021. Pre- and post-intervention learner assessments were conducted. Out of all 180 residents, 146 UCLA IM and IM/P residents completed pre- and post-Virtual Physical Examination curriculum surveys, which were not uniquely linked to individuals. Residents reported statistically significant increased confidence levels in performing a targeted virtual physical examination (P<.001; 95% CI 0.97-1.35), engaging patients or caregivers to assist in virtual examinations (P<.001; 95% CI 0.76-1.21), and using remote monitoring devices (P<.001; 95% CI 0.58-1.03). Our results demonstrate that, within our IM and IM/P residency programs, a formalized telehealth curriculum significantly improved residents' confidence in delivering virtual care.

Aspects of the use of medical devices for remote patient monitoring

Aspects of the use of medical devices for remote patient monitoring

Heart Failure Remote Monitoring: A Review and Implementation How-To.

Heart failure (HF) is a significant clinical and financial burden worldwide. Remote monitoring (RM) devices capable of identifying early physiologic changes in decompensation have the potential to reduce the HF burden. However, few trials have discussed at length the practical aspects of implementing RM in real-world clinical practice. The present paper reviews current RM devices and clinical trials, focusing on patient populations, outcomes, data collection, storage, and management, and describes the implementation of an RM device in clinical practice, providing a pragmatic and adaptable framework.

A Future of Smarter Digital Health Empowered by Generative Pretrained Transformer.

Generative pretrained transformer (GPT) tools have been thriving, as ignited by the remarkable success of OpenAI's recent chatbot product. GPT technology offers countless opportunities to significantly improve or renovate current health care research and practice paradigms, especially digital health interventions and digital health-enabled clinical care, and a future of smarter digital health can thus be expected. In particular, GPT technology can be incorporated through various digital health platforms in homes and hospitals embedded with numerous sensors, wearables, and remote monitoring devices. In this viewpoint paper, we highlight recent research progress that depicts the future picture of a smarter digital health ecosystem through GPT-facilitated centralized communications, automated analytics, personalized health care, and instant decision-making.

Development of a novel virtual reality-enabled remote monitoring device for maintenance of cathodic protection systems on oil and gas pipelines

Periodic inspections are required for oil and gas pipelines equipped with cathodic protection systems (CPS) to prevent corrosion. This inspection takes time and requires money, mobilisation of specialised staff, and accessibility of pipeline right of way which is often hindered by security issues, and bad terrain. A novel virtual reality-enabled remote monitoring device, developed using the NACE SP0169 standard, which measures the pipe-to-soil potential (PSP) reading, transmits the measured data to an IoT server, and a virtual environment for analysis and feedback while providing an immersive experience to the user, all in real-time, is presented. The hardware and software components are developed using Sensors, Arduino Mega 2560 board, AWS Sumerian 1.2.0 software, ThingSpeak IoT server, Blender modelling software and AutoCAD. When implemented on real test posts of oil and gas facilities and compared with the traditional methodology, the system showed consistency of data measurement and analysis, with real-time feedback to users, and a Spearman rank’s correlation coefficient of 0.998944. The study is significant as it provides the oil industry with an expert, easy-to-understand tool which helps to reduce the rate of oil spillage and losses through corrosion.

Use of Remote Physiologic and Therapeutic Monitoring Following Total Knee Arthroplasty.

Remote physiologic monitoring (RPM), or remote therapeutic monitoring (RTM), has grown exponentially for the management of chronic medical diseases in Medicare patients. More recently, the application of this technology has ventured into the orthopaedic arena, and more specifically, for total joint arthroplasty. Platforms to expedite this monitoring can provide continuous biodata feedback on digital biomarkers to patients and surgeons, which can potentially help improve and create novel patient-specific recovery pathways. Furthermore, various devices developed for this monitoring might help obviate the need for frequent emergency room visits, readmissions, and prolonged outpatient physical therapy sessions, as well as reduce complications and increase patient satisfaction scores after total joint arthroplasty surgery. However, while there are a number of potential benefits to technology for this type of care, its application following total knee arthroplasty has not been well-studied. Therefore, after an overview of the usage of RPM and RTM, the purpose of this study was to review the current literature regarding three common remote monitoring technologies: 1) smartphone apps; 2) wearables; and 3) combined smartphone apps and wearables. We also considered the potential financial implications of remote physiologic monitoring. A comprehensive search of the PubMed, Cochrane Library, MedLine, and Web of Science databases was performed. Three main subgroups of monitoring devices were included for analysis: smartphone apps, wearable devices, and combined wearable plus smartphone app platforms. Searches focused on remote physiologic monitoring, patient-specific advantages, financial advantages, billing and coding options, as well as overall efficacy of platforms. The current review found smartphone apps, wearables, and combined smartphone app and wearable platform technologies to be advantageous in the postoperative period following total knee arthroplasty. The wearable components can provide highly accurate and reproducible data, which the user-friendly smartphone app can relay to the patient so they can easily understand their progress. Additionally, through the apps, patients can directly access their surgical team. By constantly collecting and evaluating range of motion and functional data, the surgical team can identify if the patient is appropriately progressing through treatment or if further intervention is warranted. The incorporation of the remote physiologic monitoring devices during the post-total knee arthroplasty period shows strong promise as a progress-tracking modality. Published benefits include reduced physical therapy visits, decreased pain scores and reliance on opioids, increased activity levels as assessed by step counts, increased ability to follow less well-performing patients, reduced readmissions, reduced in-person clinic visits, and decreased postoperative costs.

Use of continuous glucose monitoring in pediatric gastroenterology allows for personalized nutrition support care – Potential for collaboration between pediatric endocrinologists and gastroenterologists

Continuous glucose monitoring (CGM) devices have been approved for the management of patients with diabetes mellitus. Some of the brands available almost completely eliminate the need for finger pricks. We aim to describe our experience with the use of CGM in two patients followed in the gastroenterology clinic due to diseases associated with hypoglycemia and how the information obtained from the devices improved care and outcomes. Data were continuously reviewed through the CGM device remote monitoring system and influenced clinical decisions related to nutrition support. CGMs are now part of standard care for patients with diabetes mellitus. The benefits of these devices and how they can improve the care of patients with disorders typically managed by the gastroenterologist need to be explored. In particular, patients with glycogen storage disorders, fatty acid oxidation defects, and ketotic hypoglycemia can benefit from GCM utilization, allowing for optimal and personalized nutritional care.

Perioperative Care Innovations: Optimizing Recovery and Reducing Complications in General Surgery

Significant progress has been made in perioperative care for general surgery with the goal of minimising postoperative complications and improving patient outcomes. This thorough analysis examines developments in the preoperative, intraoperative, and postoperative domains of the perioperative continuum. This article explores the most recent innovations influencing the profession, with a focus on patient-centered tactics, technology improvements, and interdisciplinary approaches.&#x0D; Within the context of preoperative optimisation, therapies aimed at correcting dietary deficiencies, individualised exercise programmes, and psychological preparedness are critical to improving surgical patient readiness. Improved surgical methods, such as robotics and minimally invasive surgery, revolutionise surgical accuracy while reducing trauma and facilitating a quicker recovery.&#x0D; Innovations in postoperative care, such improved recovery procedures and remote monitoring devices, speed up recovery and lower complications. Pain treatment and infection control advances in pharmacology have a major positive impact on patient comfort and lower morbidity.&#x0D; This study emphasises the value of customised treatment plans, collaborative decision-making, and specialised communication while embracing patient-centered methods. It highlights how important it is for patients to be involved in their treatment, how to promote their own autonomy, and how to improve compliance with postoperative instructions.&#x0D; This study seeks to highlight the combined influence of these breakthroughs on changing general surgery perioperative care paradigms through an examination of these advances. The perioperative setting is driven by the combination of innovative tactics, cooperation across varied healthcare specialties, and technology breakthroughs with the ultimate goal of optimising recovery and minimising problems.

Patient Outcomes Associated with the First Remote Monitoring Experience of Cardiac Implantable Electronic Devices in South Korea.

Remote monitoring of cardiac devices reduces unnecessary outpatient visits and increases patient satisfaction. We aimed to evaluate remote monitoring in terms of patient satisfaction, economic efficiency, and safety. This was a single university hospital survey. The time/medical cost efficacy and satisfaction index were evaluated using a questionnaire to investigate patient satisfaction before and after remote monitoring in patients using Biotronik implantable cardiac devices. The questionnaire was adopted and modified from Hwang's 2020 Survey on Telehealth Patient Experience. Remote monitoring was associated with a decrease in total outpatient visits. Of 1270 remote monitoring-related alerts clinicians received during the study period, more than 95% were from patients with pacemakers. Still, the severity of alerts was higher for implantable cardioverter defibrillators and cardiac resynchronization therapy with defibrillators. The post-RM survey results demonstrated that patients were generally satisfied with RM, perceived it as cost-effective, and found that RM facilitated health management without disrupting their daily routines. The study participants were satisfied with their first remote monitoring experience and reported having time- and cost-savings by using remote monitoring. Remote monitoring-related alerts from high-voltage devices were more severe and required medical intervention.

P-043 Leveraging wearable devices for remote patient monitoring facilitate earlier CRS detection following CAR-T therapy in relapsed/refractory multiple myeloma (RRMM): early results from an IIT

P-043 Leveraging wearable devices for remote patient monitoring facilitate earlier CRS detection following CAR-T therapy in relapsed/refractory multiple myeloma (RRMM): early results from an IIT

Cloud Server-Assisted Remote Monitoring and Core Device Fault Identification for Dynamically Tuned Passive Power Filters

Reliability and safety are crucial for the operation of a dynamically tuned passive power filter (DTPPF). Safe performance of DTTPFs implies complete normal filtering without failure within a specified period. To prevent potential disaster or economic loss, it is desirable to achieve early warning of any core device faults in a DTPPF based on its running state and to optimize its harmonic mitigation performance. In this paper, we explore effective methods for identifying core device faults in DTPPFs. First, we summarize the characteristic parameters of faults, running state parameters, parameters required for fault monitoring, and fault type parameters. Then, a cloud server-assisted remote monitoring and fault identification system for DTPPF is proposed, which consists of monitoring system’s architecture and cloud servers’ software architecture as well as software design of the back-end service layer and functional design of the front-end application layer. Our experiments demonstrate that the proposed system can monitor the real-time operational status of the DTPPF, enabling remote diagnosis and identification of core device faults. Moreover, it is user-friendly, as it is capable of optimizing equipment maintenance schedules and utilizing manufacturers’ service capacities. Therefore, this research provides a theoretical foundation for harmonic mitigation in low-voltage distribution networks and is valuable for practical engineering applications in industrial power grids.

Intrinsic Properties of Composite Double Layer Grid Superstructures

This paper examined the opportunities of composite double-layer grid superstructures in short-to-medium span bridge decks. It was empirically shown here that a double-layer grid deck system in composite action with a thin layer of two−way reinforced concrete slab introduced several structural advantages over the conventional composite plate-girder superstructure system. These advantages included improved seismic performance, increased structural rigidity, reduced deck vibration, increased failure capacity, and so on. Optimally proportioned space grid superstructures were found to be less prone to progressive collapse, increasing structural reliability and resilience, while reducing the risk of sudden failure. Through a set of dynamic time-series experiments, considerable enhancement in load transfer efficiency in the transverse direction under dynamic truck loading was gained. Furthermore, the multi-objective generative optimization of the proposed spatial grid bridge (with integral variable depth) using evolutionary optimization methods was examined. Finally, comprehensive discussions were given on: (i) mechanical properties, such as fatigue behavior, corrosion, durability, and behavior in cold environments; (ii) health monitoring aspects, such as ease of inspection, maintenance, and access for the installation of remote monitoring devices; (iii) sustainability considerations, such as reduction of embodied Carbon and energy due to reduced material waste, along with ease of demolition, deconstruction and reuse after lifecycle design; and (iv) lean management aspects, such as support for industrialized construction and mass customization. It was concluded that the proposed spatial grid system shows promise for building essential and sustainable infrastructures of the future.

Efficacy of a web-based healthcare innovation to advance the quality of life and care of patients with an implantable cardioverter defibrillator (ACQUIRE-ICD): a randomized controlled trial.

Modern clinical management of patients with an implantable cardioverter defibrillator (ICD) largely consists of remote device monitoring, although a subset is at risk of mental health issues post-implantation. We compared a 12-month web-based intervention consisting of goal setting, monitoring of patients' mental health-with a psychological intervention if needed-psychoeducational support from a nurse, and an online patient forum, with usual care on participants' device acceptance 12 months after implantation. This national, multi-site, two-arm, non-blinded, randomized, controlled, superiority trial enrolled 478 first-time ICD recipients from all 6 implantation centres in Denmark. The primary endpoint was patient device acceptance measured by the Florida Patient Acceptance Survey (FPAS; general score range = 0-100, with higher scores indicating higher device acceptance) 12 months after implantation. Secondary endpoints included symptoms of depression and anxiety. The primary endpoint of device acceptance was not different between groups at 12 months [B = -2.67, 95% confidence interval (CI) (-5.62, 0.29), P = 0.08]. Furthermore, the secondary endpoint analyses showed no significant treatment effect on either depressive [B = -0.49, 95% CI (-1.19; 0.21), P = 0.17] or anxiety symptoms [B = -0.39, 95% CI (-0.96; 0.18), P = 0.18]. The web-based intervention as supplement to usual care did not improve patient device acceptance nor symptoms of anxiety and depression compared with usual care. This specific web-based intervention thus cannot be recommended as a standardized intervention in ICD patients.

Remote monitoring of cardiac implantable electronic devices and disease management.

This reviews the transition of remote monitoring of patients with cardiac electronic implantable devices from curiosity to standard of care. This has been delivered by technology evolution from patient-activated remote interrogations at appointed intervals to continuous monitoring that automatically flags clinically actionable information to the clinic for review. This model has facilitated follow-up and received professional society recommendations. Additionally, continuous monitoring has provided a new level of granularity of diagnostic data enabling extension of patient management from device to disease management. This ushers in an era of digital medicine with wider applications in cardiovascular medicine.

Real Home Automation

Real home automation is a system that allows for the remote control and monitoring of various household appliances and devices, such as lights, thermostats, and security systems, through a central hub or smartphone app. This technology can increase energy efficiency, enhance convenience, and improve overall home security.

Role of nursing in the implantation of the injectable holter

Abstract Funding Acknowledgements Type of funding sources: None. Main funding source(s): No Introduction The injectable Holter monitor is a useful tool in the evaluation of patients with recurrent syncope of unknown etiology and in patients with suspected embolic paroxysmal AF. This device monitors heart rhythm for 2-3 years. In our center, the implantation and follow-up of this type of patient is carried out exclusively by nursing, with three centers in Andalusia performing this type of procedure. The objective is to describe the injectable holter implant procedure prepared by nursing. Material and Method Through the bibliographic search in the CUIDEN and PubMed databases, a procedure for the implantation of an injectable Holter monitor by nursing has been developed. The types of Holter that are implanted in the Hemodynamics Unit, the implantation procedure, as well as the necessary material are described. When an injectable Holter monitor is implanted in a patient, a series of steps are followed, such as checking them the next day, conducting health education, as well as delivering the remote monitoring device. Results Since 2010, 266 devices have been implanted, with the nursing staff being fully responsible for both implanting and monitoring them. In the insertion procedure, the previous preparation of the patient, information, the necessary material for the implant, procedure and activation of the device by means of a programmer are highlighted. After the implant, monitoring and remote control are performed by the nursing staff for functional tests. Conclusions The complete approach to the implantation and follow-up of the injectable Holter monitor by nursing has allowed us to grow, helping closely in the diagnosis and treatment of heart rhythm disorders. The utility in the early detection of cardiac events in the injectable Holter monitor is a leap in the quality of life of patients, in the optimization of resources and in response time.

Modern technology meets established health care. Challenges and opportunities in fulfilling the promises of remote device monitoring in heart failure

Modern technology meets established health care. Challenges and opportunities in fulfilling the promises of remote device monitoring in heart failure

Vision for the 12 LABOURS Digital Twin Platform.

Clinical translation of personalised computational physiology workflows and digital twins can revolutionise healthcare by providing a better understanding of an individual's physiological processes and any changes that could lead to serious health consequences. However, the lack of common infrastructure for developing these workflows and digital twins has hampered the realisation of this vision. The Auckland Bioengineering Institute's 12 LABOURS project aims to address these challenges by developing a Digital Twin Platform to enable researchers to develop and personalise computational physiology models to an individual's health data in clinical workflows. This will allow clinical trials to be more efficiently conducted to demonstrate the efficacy of these personalised clinical workflows. We present a demonstration of the platform's capabilities using publicly available data and an existing automated computational physiology workflow developed to assist clinicians with diagnosing and treating breast cancer. We also demonstrate how the platform facilitates the discovery and exploration of data and the presentation of workflow results as part of clinical reports through a web portal. Future developments will involve integrating the platform with health systems and remote-monitoring devices such as wearables and implantables to support home-based healthcare. Integrating outputs from multiple workflows that are applied to the same individual's health data will also enable the generation of their personalised digital twin.Clinical Relevance- The proposed 12 LABOURS Digital Twin Platform will enable researchers to 1) more efficiently conduct clinical trials to assess the efficacy of their computational physiology workflows and support the clinical translation of their research; 2) reuse primary and derived data from these workflows to generate novel workflows; and 3) generate personalised digital twins by integrating the outputs of different computational physiology workflows.

Real-life data on the workload of cardiac implantable electronic device remote monitoring in a large tertiary center.

Cardiac implantable electronic devices (CIED) and implantable loop recorders (ILR) are increasingly monitored by systems allowing remote transmission of data from the patient to the hospital. Remote monitoring (RM) has been shown to increase patient satisfaction and safety. However, real-life data on the number and causes of the RM transmissions, and actions initiated by them are scarce. A total of 3446 patients with CIED and 92 patients with ILR were included in the study. Data on the number of alerts, scheduled and patient-initiated transmissions as well as the causes and actions initiated by the transmissions were systematically collected from March 1 to December 30, 2022. The data was subdivided by the device type. During the study period 7087 remote CIED and 1212 ILR transmissions were generated, (0.2 and 1.3 per patient per month), respectively. Of these transmissions 49% (4084) were automatic alerts, and 29% (2434) and 22% (1781) were scheduled and patient initiated, respectively. Most of the CIED alerts (73%) and the scheduled transmissions (90%) were nonactionable, and only 7% and 5% led to in-office follow-up, respectively. Off all ILR alerts (1011) PM implantation was scheduled to 11 patients. RM transmissions were common, but most of them were nonactionable. These real-life findings indicate that detailed analysis of the causes of the RM transmissions is important for optimization of the remote follow-up workload.