La bitácora de Fran Sánchez Laguna
“Publican en JMIR un interesante estudio sobre las experiencias y percepciones de pacientes y médicos en un programa de telemonitorización en pacientes con insuficiencia cardíaca.
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Seto E et al, J Med Internet Res, 14(1)
Background:
Previous trials of heart failure telemonitoring systems have produced inconsistent findings, largely due to diverse interventions and study designs.
Objectives:
The objectives of this study are (1) to provide in-depth insight into the effects of telemonitoring on self-care and clinical management, and (2) to determine the features that enable successful heart failure telemonitoring.
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Hasan A, Paul V. European Heart Journal, 32(12)
Clinical management of refractory heart failure remains challenging, with a high rate of rehospitalizations despite advances in medical and device therapy. Care can be provided in person, via telehomecare (by telephone), or telemonitoring, which involves wireless technology for remote follow-up. Telemonitoring wirelessly transmits parameters such as weight, heart rate, or blood pressure for review by health-care professionals. Cardiac implantable devices (defibrillators and cardiac resynchronization therapy) also transmit continually interrogated physiological data, such as heart rate variability or intrathoracic impedance, which may be of value to predict patients at greater risk of hospitalization for heart failure.
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Bui AL, Fonarow GC. Journal of the American College of Cardiology, 59(2)
With a prevalence of 5.8 million in the United States alone, heart failure (HF) is a common syndrome associated with substantial morbidity, mortality, and healthcare expenditures. Close to 1 million HF hospitalizations occur annually in the United States, with the majority of these resulting from worsening congestion in patients previously diagnosed with HF. An estimated $37.2 billion is spent each year on HF in the United States. These statistics emphasize the need to develop and implement more effective strategies to assess, monitor, and treat HF. It has also become increasingly apparent that interventions geared toward identifying and monitoring subclinical congestion would be of value in the home management of chronic HF.
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McBeth PB et al, The Journal of Trauma, 71(6)
BACKGROUND:
Apnea (APN) and pneumothorax (PTX) are common immediately life-threatening conditions. Ultrasound is a portable tool that captures anatomy and physiology as digital information allowing it to be readily transferred by electronic means. Both APN and PTX are simply ruled out by visualizing respiratory motion at the visceral-parietal pleural interface known as lung sliding (LS), corroborated by either the M-mode or color-power Doppler depiction of LS. We thus assessed how economically and practically this information could be obtained remotely over a cellular network.
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Janet Fang, Smartplanet
“Cellphones display your vital signs and take ultrasound images of your heart. Genetic scans of malignant cells match your cancer to the most effective treatment. Virtual house calls and remote monitoring could replace doctor visits and even hospitalizations… medicine is on the verge of an overhaul.
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aguitarte, Somos Medicina
“La tecnología de consumo ha avanzado mucho en los últimos años, mientras tanto los dispositivos sanitarios que usan los pacientes para el seguimiento de sus enfermedades parecen salidos de un recuerdo de hace 20 años.
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rteston, Buzz e-sante
“Acronyme de solution intégrée de monitoring de patients en Pharmacie, Sympad est un dispositif de télésurveillance d’indicateurs pertinents traités en temps réel en pharmacie ou à domicile, permetant d’une part d’améliorer la qualité et la sécurité des soins sur les lieux de vie et d’autre part d’en diminuer les coûts et participer ainsi à des économies de santé substantielles.
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Dominic Tyer, Digital Intelligence Blog
“The European Commission is to set up an eHealth network to help drive technological innovations such as tele-monitoring and e-prescriptions, and improve the safety and efficiency of patient care.
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Brian Dolan, mobihealthnews
“Approximately 2.2 million patients globally used a home-based remote monitoring device as of the end of 2011, according to a recent report from Berg Insight. The metric only accounts for devices that use fixed wireless, cellular, and fixed line connections.
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Neil Versel, mobihealthnews
“Mobile adoption just keeps marching forward, but someone had best solve the payment issue sooner rather than later.
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Anker SD et al, The Lancet, 378(9806)
We agree with Alexander Clark and David Thompson about the complexity of telemedicine and remote patient management interventions and that in many cases “interventions with the same label are not the same interventions”. Hence we proposed the concept of “four generations of telemedicine” in our Review. We maintain that the effectiveness of telemedicine and remote patient management in heart failure is not established.
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Inglis SC et al, The Lancet, 378(9806)
We commend Stefan Anker and colleagues on their excellent Review of telemonitoring in chronic heart failure (CHF) and on their proposed classification of telemedical remote management systems according to the type of data transfer, decision ability, and level of integration.
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Clark AM, Thompson DR. The Lancet. 378(9806)
“Everything works” or “nothing works”: clinicians often grapple with these dichotomous and non-qualified conclusions in systematic reviews. Seldom does this occur in the same paper.
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Bernie Monegain, Healthcare IT News
“SweetSpot Diabetes Care, a Portland, Ore.-based company, will remotely monitor blood glucose levels in veterans with diabetes, beginning with a pilot in Dayton, Ohio. An award from the Department of Veteran Affair’s industry innovation competition, known as VAi2, will pay for the initiative aimed at improving care and reducing complications.
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Chris Gullo, mobihealthnews
“St. Jude Medical announced new features for its Merlin.net remote patient monitoring offering, Patient Care Network (PCN), including mobile alerts for physicians and improved data export to EHRs.
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Cristiano Codagnone, Ioannis Maghiros, David Broster, Francisco Lupiañez, Maria Lluch, JRC
“This report contains the main findings of the scoping and exploratory research carried out in the course of 2010 by the SIMPHS research team (part of the TIESC Action within the Information Society Unit at IPTS1) on the broadly defined issue of assessing the micro and macro impact of Integrated Personal Health and Social Care Services (IPHS, see infra § 1.1 for the definition). SIMPHS, which stands for Strategic Intelligence Monitor of Personal Health Systems, is a three-year project collaboration between IPTS and Unit H1 (ICT for Health) of the European Commission’s Directorate General Information Society.
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Deschildre A et al, The European Respiratory Journal, 2011
Some children with severe asthma develop frequent exacerbations despite intensive treatment. we sought to assess the outcome (severe exacerbations and health-care use, lung function, quality of life, maintenance treatment) of a strategy based on daily home spirometry with teletransmission to an expert medical centre and wether it differs from that of a conventional strategy. 50 children with severe uncontrolled asthma were enrolled in a 12-month prospective study and randomized into two groups: treatment managed with daily home spirometry and medical feedback (HM) and conventional treatment (CT).
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Kurtz B et al, Journal of Telemedicine and Telecare, 17(6)
We studied 138 patients admitted for heart failure (HF). Patients were allocated one of three treatment strategies. Group 1 (G1, n = 50) were given usual care for HF, Group 2 (G2, n = 56) received a multi-disciplinary team approach, while Group 3 (G3, n = 32) had home telephone self-monitoring. Telemonitoring was based on the answers to three simple queries about bodyweight change, dyspnoea and general health. The system stratified the HF severity of each patient once a week, and recommended a prompt medical appointment or simple follow-up.
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Lee Gomes, Technology Review
“Excitement over the iPhone and its family of miracle devices is rubbing off on health care, with doctors, policy makers, and especially companies touting a mobile-inspired technology called remote health monitoring as the next big thing in medicine.
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