Designing and Implementation of a Heart Failure Telemonitoring System

Abstract

Introduction:The aim of this study was to identify patients at-risk, enhancing self-care management of HF patients at home and reduce the disease exacerbations and readmissions.Method:In this research according to standard heart failure guidelines and Semi-structured interviews with 10 heart failure Specialists, a draft heart failure rule set for alerts and patient instructions was developed. Eventually, the clinical champion of the project vetted the rule set. Also we designed a transactional system to enhance monitoring and follow up of CHF patients. With this system, CHF patients are required to measure their physiological measurements (vital signs and body weight) every day and to submit their symptoms using the app. additionally, based on their data, they will receive customized notifications and motivation messages to classify risk of disease exacerbation. The architecture of system comprised of six major components: 1) a patient data collection suite including a mobile app and website; 2) Data Receiver; 3) Database; 4) a Specialists expert Panel; 5) Rule engine classifier; 6) Notifier engine.Results:This system has implemented in Iran for the first time and we are currently in the testing phase with 10 patients to evaluate the technical performance of our system. The developed expert system generates alerts and instructions based on the patient’s data and the notify engine notifies responsible nurses and physicians and sometimes patients. Detailed analysis of those results will be reported in a future report.Conclusion:This study is based on the design of a telemonitoring system for heart failure self-care that intents to overcome the gap that occurs when patients discharge from the hospital and tries to accurate requirement of readmission. A rule set for classifying and resulting automated alerts and patient instructions for heart failure telemonitoring was developed. It also facilitates daily communication among patients and heart failure clinicians so any deterioration in health could be identified immediately.

The Importance of Information and Communication Technologies (Ict) to Promote Information, Self-Care and Empowerment in Patients With Chronic Diseases

“…We also verified that ICT promote self-efficacy in patients with rheumatic disease [18], which is reflected in increased confidence and ability to perform daily activities, with reduced pain and increased functional capacity [22]. The majority of previous studies with ICT have demonstrated positive changes in health status, and sometimes increase quality of life in patients with crhonic diseases [22] which corroborates a study that we selected [19]. Also, describing that ICT increased the opportunities to patients for accessing information that disease's self-management [15], [16], [17], [18], [19], the management of symptoms, the identification of exacerbations and therapeutic management [15], [16], [19].…”

“…We verified that the ICT's were identical in the different studies, the web intervention provided throughout the informative platforms and of registration as well as of e-learning where the more evidenced. It was possible to identify that the ICT's have positive effects in the patients with chronic diseases, which was verified that these have effects in the promotion of self-care and in selfmanagement of their health [15], [16], [17], [18], [19]. One of the results of the studies was the improvement of the overall increase of the patient's heath status, linked with a bigger knowledge and information about the control of symptoms and therapeutic regime [16] that allowed a better selfmanagement of their condition, decreasing the visits to the hospital [15].…”

“…). It was also verified that the interventions based in these ICT's allow an increase of adhesion of behaviours associated to healthy lifestyles such as: diet, physical exercise, smoking cessation that have positive effects specially in patients with diabetes, DPOC and heart diseases [15], [17], [19]. ).…”

Mobile Phone Apps to Support Heart Failure Self-Care Management: Integrative Review

“…Several of these studies demonstrated usability and potential efficacy for improving HF outcomes. Evidence shows that few mHealth apps are under development in countries such as Russia [57] and Iran [58]. Given the global public health burden of HF, large-scale studies to test these mHealth apps or systems for efficacy is warranted in America and around the world.…”

Developing a mobile health application for wound telemonitoring: a pilot study on abdominal surgeries post-discharge care

“…In Iran, the implementation of this technology as a platform for post-acute care has been less addressed. It has received more attention in the management of chronic diseases such as heart disease [ 23 ] or diabetes self-care [ 24 , 25 ].…”