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- ••• 1.1: Background.
- 1.2: ••• Overview.
- 1.3: ••• Project partners.
- 1.4: ••• Funding.
- 2: Remote monitoring system.
- 3: Clinical trial.
- 4: Patient advisor.
- 5: Press.
- 6: Publications.
- 7: Documents.
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What exactly is remote patient monitoring?
- A patient is measuring his blood pressure (picture: BMWi/ next generation media 2008)
The picture shows how remote patient monitoring works: A patient is measuring blood pressure during everyday activity. Special feature: The blood pressure meter is equipped with a sensor which automatically transfers vital parameters into a database situated in a hospital. Innovative transfer techniques are used in the field of telecommunication (in Germany this is called telemedicine). In a telemedical center, medical experts are available around the clock to react to any data changes of blood pressure, weight and ECG (electrocardiogram). In case of concerns they contact the patient or refer him to his GP. It is an objective “early warning system” for cardiac deterioration and enables the timely adjustment of the therapy.
In short: Compared to usual care, remote patient monitoring resolves the physical distance between the patient and his caring physicians via telecommunication techniques (e.g., mobile networks or the internet).
Which kinds of remote patient monitoring exist?
• Remote monitoring is applied by physicians for the transfer of patient related data, to have a second look on them and to exchange knowledge („doc2doc“). It is used in continuous medical education, in the therapy of complicated cases or in remote areas.
• Remote monitoring is also applied between physicians and patients („doc2patient“). It is especially useful for the monitoring of vital parameters, but if required also for diagnosis and treatment – this is the case in the research and development project „Partnership for the Heart“.
Remote monitoring – which means the observation of vital parameters like weight or blood pressure, is a daily routine in the telemedical centers situated at the Charité Berlin and at the Robert Bosch Hospital in Stuttgart. Medical experts provide telediagnoses in case of deviant measurement data and coordinate corresponding activities. In cases without pathological findings they inform patients and their own GP or cardiologist. If the contact person is out of reach (e.g., on the weekend), they initiate a teletherapy themselves (e.g., drug dose adoption). In case of emergency they send an emergency physician immediately and support first aid via telephone (e.g., heart-lung-resuscitation or use of a streaming ECG).
Why remote patient monitoring on chronic heart failure?
Remote monitoring is especially appropriate to chronic heart failure therapy – experts call this disease a „reference indication”, for three reasons:
• Patients mostly realize worsening of cardiac function with delay (see illustration). Nevertheless, deterioration can be detected at an earlier stage if objective vital data are analyzed, even before the patient notes it.
• In Germany, as in other European countries, population is aging. At the same time there is a substantial increase of chronic diseases. In 2006, about 1.5 million people in Germany suffered from chronic heart failure, about 317,000 times patients came to hospital. Heart failure is the most frequent reason for hospital. Diagnosis and therapy are cost-intensive: about 2% of the whole German health expenditures.
• People who suffer from chronic heart failure experience two frequent complications: cardiac decompensation or sudden death. Especially cardiac decompensation can be detected at an early stage and treated applying remote monitoring.
This is why remote monitoring offers an „early warning system“ for subtle changes and enables physicians to timely adjust the therapy.