From the mHealthNews archive

Solving the remote monitoring puzzle

By Eric Wicklund

For people with complex chronic conditions, a "snapshot" won't work.

That's why researchers at Cedars Sinai in Los Angeles are testing out a remote patient monitoring platform that continuously collects biometric information from the patient at home and uploads that data to a cloud-based platform. The project combines the Internet of Things with the latest in wearable sensors and data analytics and is designed to keep patients away from the hospital or doctor's office, where providers can only act on snapshots of data that don't accurately reflect a patient's ongoing condition.

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"We need devices that are able to capture the diagnostic nature of the human body," Raj Khandwalla, MD, director of cardiovascular education at the Cedars Sinai Medical Foundation, says of the pilot project, involving about 20 patients with high-risk heart failure. "When you combine that with advanced data analytics, that's where the future lies."

Khandwalla's project pulls in wearable sensors that collect data from the patient in his or her home, then push that data into Sentrian's Remote Patient Intelligence (RPI) platform, a cloud-based monitoring and analytics solution that took home the President's Award for Innovation in Remote Health Care at this year's American Telemedicine Association conference.

The key to the project is that Khandwalla is collecting a wide range of information, and Sentrian's platform is analyzing that information for more than just issues related to heart failure. Martin Kohn, MD, Sentrian's chief medical scientist, said the analytics being deployed now are more complex than in past studies, because people with high-risk chronic conditions generally face more than one health issue or have problems that lead to other medical emergencies.

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"We don't really know which data (being collected by the sensors) has the predictive power" to help providers pinpoint a medical issue, he said. "And it could be any combination of features that helps to predict something."

"The process of undergoing home monitoring for chronic patients has actually been around for 20 years, but it hasn't been done well," Kohn added. "It's been an overly simplistic approach that targets one chronic condition. If you focus on just one, however, you miss many opportunities to help out these patients."

According to Khandwalla, remote patient monitoring combined with analytics has the potential to keep a significant number of people with chronic conditions out of the hospital. Studies have shown that as many as half of the patients diagnosed with chronic heart failure are readmitted within six months, though that number can be cut in half if some sort of home monitoring program is implemented.

"We're at the beginning stages of the IoT movement," he said, "and just starting to develop sensors that can passively collect the data from a patient without the patient doing that much. What we want to (identify) is when patients don't take their medications or don't follow their care guidelines. How can we reach out and motivate them?"

"We're first proving this on the sickest of the patients," Khandwalla added. "And so far the early results have been good, but we need more populations, more patients, more hard points. The ultimate standard is going to be, did we increase life expectancy?"

Kohn said advanced home monitoring platforms also have to develop analytics that weed out false alarms and costly interventions that aren't necessary. Those expensive, unnecessary and aggravating moments have doomed many a remote patient monitoring project and are scaring a few companies away from the market.

"That's why this (pilot) is so important," he said. "If we can show that it has value … across populations, it will be embraced by healthcare providers and pharma."

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