Innovative telemonitoring system for cardiology: from science to routine operation
Innovative telemonitoring system for cardiology: from science to routine operation
复制标题
创新的心脏病学远程监护系统：从科学到常规操作
DOI：
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发表时间：
2010
影响因子：
6.7
通讯作者：
G. Schreier
中科院分区：
文献类型：
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作者：
P. Kastner;J. Morak;R. Modre;A. Kollmann;C. Ebner;F. Fruhwald;G. Schreier
总结目标：奥地利MOBITEL（基于移动的的心力衰竭患者远程监护）试验的结果表明，基于家庭的远程监护可改善慢性心力衰竭（CHF）患者的结局，并减少住院频率和住院时间。根据经验教训，我们评估了薄弱环节，为日常业务扫清道路。研究方法：我们根据ESC指南的建议和整个试验过程中获得的经验分析了该系统，以确定潜在的改进。已确定以下组件：具有最高可用性的患者终端、记录药物摄入和健康的集成方式以及CHF恶化的自动事件检测。因此，该系统通过近场通信（NFC）技术和事件管理工具进行了扩展。结果：30名成人（14名女性，中位数51岁）的可用性评价。IQR[45-65]）显示，21名（8名f）在阅读分步手册后能够立即操作系统。8名（6名女性）需要一次演示，1名男性（80岁）无法操作血压计。经修订的系统于2009年3月开始日常运作。9个月内，15例患者（4例女性，中位年龄74岁）。IQR[71-83]，所有NYHA-III）发送了17，149个条目。由于2天内体重增加超过2kg，检测到43起事件。记录了49次治疗调整。3名患者停止使用该系统，2名（1名女性）因不依从，1名（男性，82岁）因死亡。总体而言，每天数据传输的遵守率为78%。结论：初步结果证实了经修订的远程监护系统在常规手术中的适用性。引文：Kastner P，MorakJ，Modre R，Kollmann A，Ebner C，Fruhwald FM，Schreier G.创新的心脏病学远程监护系统：从科学到常规操作。应用临床信息2010; 1：165-176 http://dx.doi.org/10.4338/ACI-2009-12-RA-0021
Summary Objective: Results of the Austrian MOBITEL (MOBIle phone based TELemonitoring for heart failure patients) trial indicate that home-based telemonitoring improves outcome of chronic heart failure (CHF) patients and reduces both frequency and duration of hospitalizations. Based on lessons learned, we assessed the weak points to clear the way for routine operations. Methods: We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements. The following components have been identified: a patient terminal with highest usability, integrated way to document drug-intake and well-being, and automated event detection for worsening of CHF. As a consequence the system was extended by Near Field Communication (NFC) technology and by an event management tool. Results: Usability evaluation with 30 adults (14f, median 51y. IQR[45-65]) showed that 21 (8f) were able to immediately operate the system after reading a step-by-step manual. Eight (6f) needed one time demonstration and one man (80y) failed to operate the blood pressure meter. Routine operation of the revised system started in March 2009. Within 9 months, 15 patients (4f, median 74y. IQR[71-83], all NYHA-III) transmitted 17,149 items. 43 events were detected because of body weight gain of more then 2kg within 2 days. 49 therapy adjustments were documented. Three patients stopped using the system, two (1f) because of non-compliance and one (m, 82y) because of death. Overall, the rate of adherence to daily data transfer was 78%. Conclusion: First results confirm the applicability of the revised telemonitoring system in routine operation. Citation: Kastner P, MorakJ, Modre R, Kollmann A, Ebner C, Fruhwald FM, Schreier G. Innovative telemonitoring system for cardiology: from science to routine operation. Appl Clin Inf 2010; 1: 165–176 http://dx.doi.org/10.4338/ACI-2009-12-RA-0021