Remote healthcare monitoring not so distant

Efficient, effective and reliable remote healthcare monitoring is a holy grail in medicine but solutions have so far proved elusive. But it took a step closer to reality with the successful conclusion of pilot tests under the E-Care project.

The project developed a comprehensive monitoring system to capture, transmit and distribute vital health data to doctors, carers and family. Pilot tests of the system indicate that doctors, nurses, patients and their families found E-Care reliable, simple to use and an effective method to improve the quality of care while reducing costs.

It monitors patients with chronic, or long-term, illnesses such as diabetes or cardiovascular disease, and patients discharged after an operation or serious medical crises, such as stroke victims. It can acquire vital information about a patient who lives far away from medical support, and it can alert medical staff if there is a dangerous change in patient’s status. With e-Care’s system doctors spend less time going to see patients and more time treating them. It also means real-time monitoring without high staff or capital costs.

“Citizens with long-term illnesses as well as those who are in post-surgery state, or predisposed to illness, need monitoring of their health until their condition becomes stable,” says project director Mariella Devoti. “They, as well as their family and friends, also need an efficient way to collaborate with their doctor and get informed about their state. Until now, monitoring of the health condition of such people could only be accomplished by prearranged visits from a doctor, or by visits to the local hospital for a check-up. However, this is an inefficient solution, as well as costly, as these visits would scarcely be on a daily basis.”

E-Care’s remote monitoring system includes a wireless intelligent sensor network (WISE), bio-medical sensors and a radio terminal. WISE consists of a series of monitors that track signs like activity, temperature, pulse, blood pressure and glucose or other personal data like weight, pain measurement and drug conformance. Data collected by the sensors are sent to the transmitter that sends them to the central system.

SMS messages sent to the drug conformance device remind the patients when they need to take medication. Patients send a confirmation once they take the drugs.

The central system includes a medical data manager (MDM) that automatically checks patient data against the patient’s record and any doctor’s notes. If there is a disturbing change in the patient’s vital signs, for example high glucose levels in a diabetic, an alarm is sent directly to the patient’s physician. This provides peace of mind for patient and family and ensures a doctor or medics can respond rapidly to any problems that arise. Similarly, the MDM can alert paramedical staff or a doctor if patient data fails to arrive when expected.

The E-Care repository stores all patient data. The collaboration module allows user to communicate using real-time synchronous message, audio conferencing or videoconference. Patients and family can confer with their doctor, or GPs or nurses can confer with a specialist.

The workflow system controls overall system processes, while user Web applications dynamically format and present the patient data depending on who is accessing the information and what access rights they have.

Researchers used standard and widely adopted technologies where possible, so the system will work with any modern hospital or clinic.

E-Care deployed in three pilot programmes between February 2003 and February 2004. “The final validation results for E-Care showed a general satisfaction among doctors and medical staff, system and medical administrators, patients and their family,” says coordinator Devoti.

Users praised its practicability, reliability, effectiveness and patient acceptance.

Diabetes specialists praised the glucose monitoring system. It allows the doctor to change patient treatment based on vital sign analysis. Similarly the blood pressure monitor was particularly of interest for patients with stroke or cardiovascular disease.

With the project validation complete the partners will fine tune the system and search for commercial opportunities. Remote monitoring is now not so distant.