e-health-connect Chronic Disease Monitoring

We implement monitoring platforms for "nursing homes" and "hospital-at-home" services

Chronic Disease Monitoring

Chronic diseases encompass a wide range of health problems including diabetes, asthma, heart diseases and sleep disorders. In many cases, chronic diseases require some kind of health monitoring, especially in the later stages of the disease progression.
Since not all chronic disease monitoring is the same, we further refine the category as follows:

  • Episodic patient monitoring is often utilized in non-critical patients to track specific indicators and identify the progress of the disease.
  • Continuous patient monitoring is often associated with acute conditions that require constant or frequent measurement of health status.
  • Patient alarm monitoring can also trigger alarms based on preset conditions that are specific to the patient and the disease.

Episodic Patient Monitoring Scenario

This use case deals with non-acute or episodic patient monitoring. In this scenario, the patient’s vital signs (e.g. heart rate, temperature) and disease-specific indicators (e.g. blood pressure, blood glucose level, ECG) are monitored to determine anomalies. The monitoring is done periodically.

All the information collected by the medical sensors is time-stamped and securely forwarded to an IT Platform and saved into a database server. The medical personnel and the family can access the information stored in the database server to monitor the progress of the disease.

As an example, certain types of diabetic patients would have to monitor their blood glucose level only a few times a day. In this case, the application would not have to poll the glucose meter as the patient is responsible for initiating the data sampling process. Since all the information is time-stamped and the patients in this scenario are not in a critical state, the latency of transmitting the information to the gateway is not critical. The data can be stored locally and securely transmitted only when a predetermined amount of data is gathered.

This use case also covers periodic, routine medical exams, where a number of medical sensors are worn by the patient during the medical exam. During the exam, all the readings are interpreted by the primary physician and archived in the patient’s database.

Continuous Patient Monitoring Scenario

In this situation, the vital signs (e.g. heart rate, temperature, pulse oximeter) are monitored on a constant basis to allow continuous measurement of patients’ health status at rest or during mild exercise for purpose of treatment adjustment or diagnosis.

The vital signs measurements waveforms (e.g. pulse pleth wave or heart rate) are streamed to an on-body data collection unit, then securely forwarded from the data collection unit to an off-body device (e.g. PC/laptop, PDA or mobile phone) for monitoring, storage and data analysis. Alternatively, the data can be sent directly to a mobile terminal.

The patient or the care provider remotely activates the on-body sensors via the off-body unit. The measurement data from the body sensors is securely transmitted continuously to the on-body unit, where it is temporarily stored. Subsequently, the recorded measurement data is securely sent to the off-body unit via batch transmission for persistent storage and further analysis by the health care provider. Optionally, an off-body unit can also be used for secure waveform viewing during the measurement. The health care professional uses the captured data to provide the appropriate diagnosis or to adjust the treatment level.

To illustrate how this use case would be deployed in real life, consider the following scenario. A patient is suspected of suffering from arrhythmia. The symptoms of this condition (e.g. fatigue, fainting and dizziness) are caused by abnormal heartbeats that can cause the heart to be less efficient. The symptoms are very brief and hard for the patient to characterize. Instead of subjecting the patient to cardiac stress to induce the abnormal heart beats while the patient is examined in a hospital, the patient is given a wearable ECG device. The ECG sensors are used to monitor the condition continuously over longer periods of time until the abnormal heartbeat is detected. Once detected, the data is securely sent to the physician for analysis. If the event is serious enough, an appropriate network device (e.g. telephone, PC/laptop, PDA) can be used to call for help.

Patient Alarm Monitoring Scenario

In this scenario, the patient’s vital signs (e.g. heart rate, temperature) and disease-specific indicators (e.g. blood pressure, ECG, EEG) are monitored on a continuous basis. The data collected by the medical sensors is time-stamped and securely forwarded to an IT Platform that acts as a patient monitoring system. Additionally, the aggregated information is stored into a database server.

At pre-determined settings, alarms are issued and responses/actions could be triggered automatically. For example, if during the monitoring of a diabetic patient the blood glucose level falls below a certain threshold, an alert can be sent to the patient, physician(s) and/or medical personnel.

The regular measurement of vital signs enables early diagnosis and warning of developing problems. Furthermore, it allows closer monitoring of the effects of medication and lifestyle, making more personalized treatment plans possible. The system contains a patient loop interacting directly with the patient to support the daily treatment. It shows the health development, including treatment adherence and effectiveness. An educated and motivated patient can improve his/her treatment compliance and health. The system also contains a professional loop involving medical professionals (e.g. alerting to revisit the care plan). The patient loop is securely connected with hospital information systems, to ensure optimal personalized care.