Use Of Remote Monitoring Systems Research Articles

Monitoring of High- and Intermediate-Risk Surgical Patients.

Monitoring of High- and Intermediate-Risk Surgical Patients.

Association of Remote Monitoring With Survival in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy: Retrospective Observational Study.

BackgroundRemote monitoring is an established, guideline-recommended technology with unequivocal clinical benefits; however, its ability to improve survival is contradictory.ObjectiveThe aim of our study was to investigate the effects of remote monitoring on mortality in an optimally treated heart failure patient population undergoing cardiac resynchronization defibrillator therapy (CRT-D) implantation in a large-volume tertiary referral center.MethodsThe population of this single-center, retrospective, observational study included 231 consecutive patients receiving CRT-D devices in the Medical Centre of the Hungarian Defence Forces (Budapest, Hungary) from January 2011 to June 2016. Clinical outcomes were compared between patients on remote monitoring and conventional follow-up.ResultsThe mean follow-up time was 28.4 (SD 18.1) months. Patients on remote monitoring were more likely to have atrial fibrillation, received heart failure management at our dedicated heart failure outpatient clinic more often, and have a slightly lower functional capacity. Crude all-cause mortality of remote-monitored patients was significantly lower compared with patients followed conventionally (hazard ratio [HR] 0.368, 95% CI 0.186-0.727, P=.004). The survival benefit remained statistically significant after adjustment for important baseline parameters (adjusted HR 0.361, 95% CI 0.181-0.722, P=.004).ConclusionsIn this single-center, retrospective study of optimally treated heart failure patients undergoing CRT-D implantation, the use of remote monitoring systems was associated with a significantly better survival rate.

Remote monitoring in industrial services: need-to-have instead of nice-to-have

PurposeThe purpose of this paper is to better understand the efficient use of remote monitoring systems (RMS) to create business value for industrial services in manufacturing firms. A business view to RMS is a key prerequisite for the successful application of the Internet of Things (IoT) in industrial services.Design/methodology/approachA qualitative multiple-case study was conducted in six engineering companies. The main source of data was semi-structured interviews with 16 managers.FindingsThe findings highlight the role of RMS in enabling manufacturing firms to collect data from customers to complement their limited knowledge about their customers. The study demonstrates the business value of using RMS in industrial services and the necessity of capturing the business value through advanced IT technologies.Research limitations/implicationsThe qualitative research design and choice of six target companies limit the findings to business-to-business manufacturing firms. Further, the focus is on the manager’s viewpoint. The findings imply new business value through an efficient use of RMS to complement direct customer contact.Practical implicationsThe study draws attention to the skilled use of advanced RMS and information and communication technology as a prerequisite for the successful application of the IoT in manufacturing firms that provide services for complex solutions and customers dispersed globally.Originality/valueThe research shows that using information collected through RMS is an important factor in creating business value in a manufacturing firm’s customer relationships. The study contributes by integrating RMS into the customer information collection process to increase the amount, validity and quality of data.

Examining the Effects of Remote Monitoring Systems on Activation, Self-care, and Quality of Life in Older Patients With Chronic Heart Failure

The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited. The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization. A total of 21 patients (mean age, 72.7 ± 8.9 years; range, 58-83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met. The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL. Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF.

ORAL PRESENTATION

ORAL PRESENTATION

Feasibility and Problems on Remote Monitoring System under Management of a Rural Hospital

Background: Our hospital is situated in rural Japan. Remote monitoring systems for cardiac-implanted devices, such as implantable pacer-generators (IPG) or implantable cardioverter-defibrillators (ICD), are usable in areas hardly accessible by means of public transportation. However, the systems are not readily operable by elderly patients.Objective: Clarification on the feasibility of using the system, and problems on the remote monitoring system.Method: Form April 2010 to May 2011, we introduced remote monitoring systems for 26 patients (mean age: 71.3±10.6; %male 84%). We retrospectively studied the patients, background, the frequency of transmission, and the data transmitted. And we compared the frequency of transmission by the elderly group (age >=75) with the younger group.Results: The implanted devices were ICD for 20 cases (16 cases, with Optivol system) and IPG for 6 cases (3 cases, with ATP system). Frequency of transmission: 95 (total), 3.8±3.2 (mean and SD), 89 (planned), 11 (unplanned), respectively. In the elderly group, the frequency of transmission: 2.1±1.7, which was smaller than in the younger group (4.9±3.5, p<0.05). Transmitted data (planned): No event 50, AT/AF 26, SVT/NST 6, VT/VF (no Tx) 6, Optivol 11, (unplanned): VT/VF (with Tx) 5, SVT 1, Optivol+AT 4.Conclusion: For elderly patients, the use of remote monitoring systems is feasible to promptly detect the device status but the difficulty of data transmission remains intact.

Implantable Sensors for Heart Failure

Heart failure (HF) affects more than 5 million Americans, and acute decompensated heart failure (ADHF) has emerged as the leading cause of hospitalization among people over the age of 65 years.1 Importantly, HF is a leading public health concern, and hospitalization expenses related to management of ADHF impose a substantial financial burden on the health care system. Additionally, readmission rates after hospitalization for ADHF may be as high as 50% at 6 months,2 and insights from the ADHERE registry suggest that a majority of patients admitted with ADHF have a history of heart failure.1 These data demonstrate that the majority of patients admitted with ADHF are known to the medical system and to medical providers, thereby creating an opportunity for upstream strategies that may be capable of detecting early HF destabilization and implementing therapies to restabilize the patient and avert hospitalization. The anticipated changes in the health care system—with a focus on bundled payments for disease management—will necessitate robust disease management programs to optimize therapy and minimize recurrent admissions once patients have been diagnosed with HF. Perhaps even more importantly, averting repeat episodes of ADHF is likely to have a stabilizing effect on the progression of HF and may improve long-term morbidity and mortality. The transition from chronic HF to ADHF involves perturbations in multiple intersecting processes including neurohormonal circuits, inflammatory mediators, cardiorenal interactions, and myocardial performance. Concurrently, derangements in comorbid illnesses such as coronary disease, atrial and ventricular arrhythmias, and hypertension also contribute to the pathophysiology of ADHF.3 Ultimately, these multiple pathways lead to an elevation in ventricular filling pressures and signs of vascular congestion, which, in concert with symptoms from impaired cardiac output, lead to the clinical constellation of ADHF. This pathophysiologic paradigm highlights multiple opportunities for detecting early changes in the processes that …