Health technology assessment review: Remote monitoring of vital signs - current status and future challenges

Abstract

Recent developments in communications technologies and associated computing and digital electronics now permit patient data, including routine vital signs, to be surveyed at a distance. Remote monitoring, or telemonitoring, can be regarded as a subdivision of telemedicine - the use of electronic and telecommunications technologies to provide and support health care when distance separates the participants. Depending on environment and purpose, the patient and the carer/system surveying, analysing or interpreting the data could be separated by as little as a few feet or be on different continents. Most telemonitoring systems will incorporate five components: data acquisition using an appropriate sensor; transmission of data from patient to clinician; integration of data with other data describing the state of the patient; synthesis of an appropriate action, or response or escalation in the care of the patient, and associated decision support; and storage of data. Telemonitoring is currently being used in community-based healthcare, at the scene of medical emergencies, by ambulance services and in hospitals. Current challenges in telemonitoring include: the lack of a full range of appropriate sensors, the bulk weight and size of the whole system or its components, battery life, available bandwidth, network coverage, and the costs of data transmission via public networks. Telemonitoring also has the ability to produce a mass of data - but this requires interpretation to be of clinical use and much necessary research work remains to be done.

Using a Modified Technology Acceptance Model to Evaluate Healthcare Professionals' Adoption of a New Telemonitoring System

“…1 Telemonitoring systems allow the capture of patients' clinical parameters (e.g., heart rate, blood pressure, blood oxygen saturation, blood glucose, electrocardiograph, and respiratory rate) by appropriate devices in a continuous or intermittent pace. 2 Although the process of data measurement and collection can be totally automated, the patients themselves are often in charge of transferring self-measured clinical data. Such information can then be transmitted either to primary care professionals or to a specialized care center where the received parameters can be integrated with other relevant information related to the state of the patient.…”

“…Such information can then be transmitted either to primary care professionals or to a specialized care center where the received parameters can be integrated with other relevant information related to the state of the patient. 2 When the measurements fall outside the established limits, the telemonitoring system can react automatically, triggering alerts to the responsible healthcare professional and allowing a timely response to deterioration. 2 Telemonitoring systems can be utilized in various contexts, such as the patient's home, scenes of medical emergencies, ambulance services, and hospitals.…”

Informática biomédica

“…En este mismo ámbito, se están desarrollando sistemas que permitan monitorear el estado de pacientes con enfermedades crónicas para poder detectar a tiempo complicaciones o evitar descompensaciones. Ejemplos de esto son las mediciones de peso para pacientes con insuficiencia cardíaca 13 , monitorización de pacientes con Alzheimer, medición de la glicemia y de la ingesta de carbohidratos para pacientes con diabetes 14 o la detección de caídas en adultos mayores.…”

Developing a Sensor based Homecare System - The Role of Bluetooth Low-Energy in Activity Monitoring

“…Research however, has described several limitations when using intelligent healthcare focused activity monitoring to obtain the data required for ADL analysis. Nangalia et al describe how sensors such as occupancy and door sensors, which are used to determine sedentary levels, have deficiencies which reduce accuracy or become limited when used in homes with multiple occupants (Nangalia et al, 2010) and therefore can't be relied upon for RPM of activity. Positioning sensors also have natural barriers with line of sight (LOS), passive infrared (PIR) sensors which monitor patients, rely on microwave emissions to detect motion which can be intercepted by walls, objects or additional occupants (Barlow et al, 2007).…”