Category Archives: Tele-ECG

Start using electronic data capture in clinical trials

A recent publication suggests that Electronic Data Capture systems, or EDCs, should be implemented in clinical trials. The EDC software can reduce the overall trial costs by an estimated $347,600 in a phase ll trial of 20 sites, 10 patients per site and a duration of 12 months plus data cleaning. See the table.

Forrester-Research-Paper-versus-EDC-cost-comparison1

Table: Forrester Research Paper versus EDC cost comparison.

In this example, monitor visits still costs $ 180,000. Vitaphone CTS provides solutions to make subjects monitor their vital signs at home. This can also enhance their trial compliance. Re-activity is a top priority to create better and more efficient clinical trials. The tools developed by Vitaphone CTS will send biosensor data immediately and thus ensure almost real-time data. Our medication adherence support system (MASS) stimulates the study subjects to take their study medication.

Remote monitoring and support enables pharmaceutical, biotechnology and medical device industries to focus on the development of the best drug or device.

Using telemonitoring solutions, investigators can improve patient safety. This might be achieved through faster notification of adverse events to the Principal Investigator, CRO or Sponsor. This will support earlier and better decision-making. Embrace technology.

Author: Indy Kavelaars

Source: Clinovo

 

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Free download: Targeting the Triple Aim on the Arizona-Mexico Border – A Summary of a Hypertension Remote Patient Monitoring Trial

The objective of this trial was to identify whether:

  1. The combination of remote patient monitoring of Home Blood Pressure Monitoring (HBPM) using alert thresholds and a Telemedicine Service Center, together with a provider team including experienced Family Care Coordinators could positively affect hypertension trends in just 30 to 60 days.
  2. The combination of remote patient monitoring described above with Family Care Coordinators could produce a positive patient experience, encompassing the patients’ perceived ease of use of the devices, interaction with staff, interest in continuing the program, and whether the patients would recommend the program to others.

Click here to get your free download of a Summary of a Hypertension Remote Patient Monitoring Trial >

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Guest blog: vitaphone USA: Silencing the Silent Killer in 30 Days

Over thirty percent of the US population has hypertension, and fewer than half of those with hypertension have it under control. Many people never know they have high blood pressure, suitably dubbed “the silent killer.” Is it any wonder then that the prevalence and hospitalization rates of congestive heart failure (CHF) have continued to rise, when the majority of patients have hypertension, very likely uncontrolled, before developing CHF? How can we get ahead of the CHF curve? In a 30 day pilot, vitaphone’s patient engagement and mHealth solution empowered cardiologists and patients to drive the average systolic blood pressure down by 20 points in just four weeks, dropping it a total of 30 points by week five.

In the newly-published study 30 Days to Make a Difference, vitaphone shows how Los Angeles area physicians’ use of remote patient monitoring and patient engagement and education by a Telemedicine Service Center (TSC) greatly shortened the provider feedback interval, facilitated more precise medication therapy, and left patients feeling more confident in their ability to manage their conditions. vitaphone’s international expertise in using similar methodologies to reduce admissions for CHF patients was a powerful ally to physicians who wanted to see if it could also address a frequent precursor to CHF: hypertension.

Interested to engage, educate and monitor patients remotely? Pick up your copy of the peer-reviewed, Journal of Healthcare Information Management (JHIM) publication 30 Days to Make a Difference: Evaluating the 30-Day Effects of a Comprehensive Remote Patient Monitoring, Shortened Provider Feedback Interval, and Patient Engagement and Education Program on Hypertensive Patients in Orlando, Florida, February 24-27, at the HIMSS14 vitaphone health solutions kiosk, Qualcomm Life Pavilion, booth 6489. Or, contact us at 702-374-1270 / btritle@vitaphoneus.com HIMSS members can also access the mobile health JHIM edition digitally at http://tinyurl.com/ohp68sw

Author: Brad Tritle, vitaphone USA

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From Holter to event monitoring!

An article of the NIH, National Institutes of Health, states that a dramatic leap in mHealth will take place when we have small, inexpensive wireless devices with sensors that monitor our physiology.[1] This means our heart rate, blood pressure, blood sodium and glucose levels, breathing patterns, brain waves and so on. These can then be transmitted to the physician, who can in his turn take actions that may spare you a trip to the hospital or even save your life.

In a clinical trial, a wireless adhesive patch was tested next to the traditional technology (the Holter) to measure heart activity. With the traditional technology, the Holter must be worn for 24 hours; it records the full 24 hours. Getting a good reading is particularly challenging when the arrhythmias occur episodically. The adhesive patch can be carried around for a longer time, like a week. The patch had 15% less use-able readings in the first 24 hours but people were asked to wear it until they could tolerate it. The subjects wore the adhesive patch for 11 days on average. Because people wore the patch longer, there were significantly more (96) use-able readings than with the Holter (61).[2] Nice data that demonstrates cardiac event monitoring works.

The cardiac event recorders, developed by Vitaphone, send the registered events within seconds to the physician or the events are firstly analyzed in the telemonitoring Service Centre and then sent through. Many event recorders are in use by Dutch hospitals. Have a look at the users list >

Cardiac event recording is available and can function as replacement for the Holter monitoring!

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: [1] NIH Directorsblog

[2] Comparison of 24-hour Holter Monitoring with 14-day Novel Adhesive Patch Electrocardiographic Monitoring. Barrett PM, Komatireddy R, Haaser S, Topol S, Sheard J, Encinas J, Fought AJ, Topol EJ. Am J Med. 2014 Jan;127(1):95.e11-7.

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NHV Congres 2014

Vitaphone Nederland zal op zaterdag 22 maart opnieuw aanwezig zijn tijdens het congres van de Nederlandse Hartfunctie Vereniging. Dit congres vindt plaats in de ReeHorst te Ede. Wij zullen hier onze laatste ontwikkelingen demonstreren op het gebied van telemonitoring en tele-ECG.

NHV congres 2014

NHV congres 2014

Bekijk het programma >

Schrijf u nu in via www.roijecongressen.com

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Survey results: Remote monitoring of cardiac implantable electronic devices

The European society of cardiology recently published the results of their survey on remote monitoring of cardiac implantable electronic devices (CIEDs). The aim of the survey was to get insight into the current use of remote monitoring (RM) of CIEDs in Europe. Responses were received from 54 centres belonging to the European Heart Rhythm Association (EHRA) electrophysiological (EP) research network.

Some interesting results: a total of 76.5% of the centres reported that they are actively using remote monitoring. RM is most used for implantable cardioverter-defibrillators and rarely or never used for routine pacemaker checkups, because the latter seems to be less cost-effective.
In 29,8% of the European centres, the delay between detection of an abnormality by RM systems and the physician’s response is within 24h.
The face-to-face 6-month check-up visits are drastically reduced by RM. Only 17.6% of all centers perform internet check-ups at predefined intervals.

Some areas for improvement.
In only 6.4% of the cases information obtained by RM is incorporated into the clinical patient file! Why is that?
Also in 25% of the centres, there is no specific workflow designed for RM. Only with a clear workflow follow-up and registration of the findings is possible.
Almost 40% of the patients reported to prefer RM as their main follow-up management, because it helps to avoid unnecessary visits to the hospital.

We believe RM will become more and more accustomed! For the 23.5% of the centres that not use RM; let’s make it happen!

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Europace Oxfordjournals

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Telemonitoring reduces the number of hospital days by 87 percent!

ECG Telecardiologie

Open de Nederlandse versie >

Research at the Scheper Hospital in Emmen, The Netherlands, shows that telemonitoring of chronic heart failure gives great improvements in several areas. The research took 2 years and included more than one hundred patients with an impaired cardiac pump function.

The care process for these patients was very differently planned through telemonitoring or remote care. The patients did daily monitoring of their weight, blood pressure and heart rate and sent these vital signs to the heart failure clinic. Through these daily monitoring, preventive and proactive actions were taken by the care professionals. This resulted in:

  • a decrease in the number of admissions per patient by 26 percent;
  • a decrease in the total number of admissions with 64 percent;
  • a reduced number of outpatient visits with 39 percent;
  • a lower average number of hospital days; a decline of 87 percent!

This is a conformation that telemedicine is effective. It also shows the possibilities of a different care model like remote care monitoring. The financial results will be published in an analysis next year. The portfolio of Vitaphone is even more extensive: we additionally offer tele-ECG monitoring. The ECG will directly be sent with or without a report to the treating physician. This means that the care professional already can act even when there are no actual symptoms or problems yet.

I like to close this blog with a quote from the cardiologist, Michiel Nagelsmit: “The deployment of e-health makes it possible for us to provide care to a larger number of patients with chronic heart failure in same available time.”

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Scheper Ziekenhuis

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Telemonitoring vermindert het aantal verpleegdagen met 87 procent!

ECG Telecardiologie

View the English version >

Onderzoek bij het Scheper Ziekenhuis in Emmen wijst uit dat telemonitoring bij chronisch hartfalen grote verbeteringen geeft. Dit onderzoek werd uitgevoerd gedurende 2 jaar onder ruim honderd patiënten met een verstoorde pompfunctie van het hart.

Het zorgproces is voor deze patiënten wezenlijk anders ingericht door middel van telemonitoring ofwel zorg op afstand. De patiënten gaven, vanuit huis, dagelijks hun gewicht, bloeddruk en hartslag door aan de Emmer hartfalenpoli. Hierdoor konden de zorgprofessionals preventief en proactief handelen. Dit resulteerde in:

  • een afname van het aantal opnames per patiënt met 26 procent;
  • een daling van het totaal aantal opnames; 64 procent minder;
  • een vermindering van het aantal polikliniek bezoeken voor de hartfalenpatiënt met 39 procent;
  • een lager gemiddeld aantal verpleegdagen met een daling van 87 procent!

Dit is een belangrijke bevestiging van de werking van telemonitoring. Het proces heeft zich aangepast aan de mogelijkheden die zorg op afstand biedt. Volgend jaar zal een financiële analyse gepresenteerd worden.
Vitaphone’s portfolio is zelfs meer uitgebreid: we bieden ook een ECG monitoring aan. Het ECG wordt met of zonder verslag direct naar de behandelend arts gestuurd. Dat kan betekenen dat er al gereageerd wordt op een situatie voordat er werkelijke klachten en problemen ontstaan!

Graag wil ik nog even afsluiten met een quote van de cardioloog Michiel Nagelsmit: “De inzet van zorg op afstand maakt het voor ons mogelijk om, met dezelfde beschikbare tijd, zorg te bieden aan een groter aantal patiënten met chronisch hartfalen”.

Auteur: Indy Kavelaars @ Vitaphone Netherlands

Source: Scheper Ziekenhuis

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When is telehealth useful?

We are overwhelmed with mHealth apps that can measure, uh, EVERYTHING; from weight to temperature, from ECG to blood glucose level. At Vitaphone, we think these developments are great. But are they groundbreaking? We don’t think so! The follow-up of these readings is essential and that’s what’s missing in mHealth apps. It is not just the presentation of data; it’s about the translation of this data to relevant information for the user. We understand the need to combine the data results, but this requires research and improved statistics.

“Researchers from the Nuffield Trust found no change in contact frequency between patients being remotely monitored and those receiving standard care.” This finding, published in Biomedcentral Health Services Research, flies in the face of the opinion that widespread use of telehealth technologies will increase demands on primary care. But simultaneously, it fails to lend support to claims that telehealth cuts GP workload. The study suggests that it might have a more significant role to play in secondary rather than primary care. The authors did note that telehealth might have a different effect on workload if the system were designed differently.

The reaction of Graeme Duncan, the Group Director of PharmaTimes World News, is the same as ours. “It is not surprising that the technology alone makes no demonstrable difference in the service utilization. However the appropriate use of technology in a well understood and researched patient pathway can make a huge difference.”

When we look at our services, they are tools for care professionals and patients to get the best treatment right from their own home. The ECG service ensures that patients can report directly to their cardiologist if they feel an arrhythmia. Our other ECG services can even report automatically on pre-defined parameters. Our medication adherence support services ensure that patients and caregivers do not forget the medication. This service is also a powerful tool for care professionals to interfere if an error is made. The medical management gets insight of the medication adherence in their organization.

These examples show additional value to the biomedical info; and that’s what brings true value to healthcare.

Author: Indy Kavelaars @ Vitaphone Netherlands
Source: Pharmatimes

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