Home or remote monitoring is applying data transmission technology from a device implanted in a patient to the specialist’s office. For this to be possible, the pacemaker or defibrillator must be capable of transmitting, and the patient must have a device at home capable of transferring this information.
Remote patient monitoring and clinical telemonitoring programs offer medical teams a sustainable and scalable way to manage chronically ill or complex patient populations at home and play a vital role in caring for patients with COVID-19 who do not require hospitalization. In addition, regularly transmitting patient data that can provide critical information about the patient’s condition will provide healthcare teams with a more holistic view of the patient and intervene before adverse events occur.
Remote patient monitoring involves the use of wearable medical devices intended for passive monitoring in the home with detailed data on vital signs, physiological biometrics, and symptomatic events such as resting heart rate, skin temperature, resting respiratory rate, activity levels, body position, cough rate, etc., changing the way doctors monitor and manage patients living with chronic diseases from home.
Monitoring currently includes pacemakers, implantable defibrillators (ICDs), subcutaneous Holter, and cardiac resynchronization devices (CRTs). These implantable systems offer multiple programmable aspects and store large amounts of diagnostic information to devise function, arrhythmia rate, patient activity, status, etc. The general scheme of operation of a monitoring system is as follows:
- Step 1: The patient has an implanted device to transmit information and transmits it regularly at a time previously programmed by the practitioner, usually at night while the patient sleeps, every day, or on the scheduled date. The device also transmits information when an event occurs (e.g., a change in device function or an arrhythmia).
- Step 2: The patient’s transmitter, which functions as a cell phone or analog landline, collects this information.
- Step 3: The patient’s transmitter sends, via multimedia message, with a restricted bandwidth for medical devices, the coded information to the company’s service center.
- Step 4: At the Service Center, the complete information is received from the device and dumped into the secure database, which the physician can review via the Internet. If the information received is for an event, the system automatically notifies the physician by SMS, fax, or e-mail (depending on the physician’s decision).
- Step 5: The physician reviews the events or the patient’s page (depending on his/her work routine) and checks the status of the device/patient to take appropriate clinical action. Nursing plays a vital role in this step since they are responsible for receiving this information in many centers.
These systems record a large amount of information stored and available to the physician from anywhere with internet access. In addition, the Web site is secure, and data can only be viewed by accessing it with assigned passwords, thus ensuring data protection.
The remote patient monitoring offerings extend the population health management and provide a comprehensive and proactive healthcare strategy to connect physicians, providers, and patients for a continuum of care.