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All Posts Tagged: Monitoring

Monitoring health – Patients overwhelmingly support it

For health monitoring, most respondents believe doctor-recommended mobile devices can help them manage care between visits.

By Jessica Davis

Regarding monitoring their health, the vast majority of Americans say they would welcome using technology and mobile devices for it, according to a recent study by the Society for Participatory Medicine, a nonprofit membership organization focused on patient engagement.

The study found 84 percent of survey respondents felt tracking blood pressure, heart rate, respiratory rate, physical activity and other data with a user-friendly mobile device between provider visits would help to better manage their health. Thanks for mobile monitoring apps.

“The important findings from the survey show patients really want to partner with physicians,” said Daniel Z. Sands, MD, co-founder, co-chair of the Society for Participatory Medicine.

“It’s not a typical service industry, like the car wash model of healthcare where the patient cruises through the system,” he added. “Providers need to engage patients, and patients want it.”

In fact, 77 percent of survey respondents felt it was both important for themselves and their healthcare provider.

ORC International interviewed more than 1,000 Americans on behalf of the Society for Participatory Medicine and found 76 percent of respondents would use a clinically accurate and easy-to-use monitoring device; 81 percent would be more likely to use a device if their provider recommended it, and 57 percent would like to use the device and share the information with their provider.

“I think many physicians believe patients just want to come in for their visits, but don’t really want to engage in their healthcare,” said Sands. “The participatory method is really important, but the question is, do physicians want to have a partnership?”

“If we get it right, we have the opportunity to leverage technology to help patients contribute to their health information without coming into the office,” he added. “This information is valuable to patients and to providers. It’s an important tool to get healthcare outside of the office.”

According to Sands, it’s a change in mindset for many providers that medical schools are attempting to combat. But it’s challenging in the constraints of a medical practice to transition to this type of care. Further research must be done on physicians to determine their issues and thoughts.

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Roche app measures Parkinson’s disease fluctuations

This is another fine example of how smartphones could be used to good effect in modern day medicine. Roche Pharma Research & Early Development (pRED) has developed a smartphone-based monitoring system for those with Parkinson’s disease (PD) that complements the traditional physician-led assessments with automated tests that continuously measure their symptom fluctuations. This could be the first time that such an app has been used to measure disease and symptom severity in a medicine development program in Parkinson’s disease.

“The app is being used in a Phase I trial run by Prothena, in collaboration with Roche in PD. In clinical trials in this area, disease disability and impairment are traditionally measured by physician assessments using the Unified Parkinson’s Disease Rating Scale (UPDRS). However, these are limited to the specific times that patients go for an appointment with their physicians. The app will enable continuous measurement of PD fluctuation every day and throughout the day. Ultimately, we hope the app can be used in future clinical development to enable  more objective measures on response to treatment to complement doctor assessments,” explains Anirvan Ghosh, Head of Neuroscience Discovery for pRED.

Patients will be asked to follow a daily routine with the app, using it every day for the duration of the trial. The routine will consist of six active tests followed by passive monitoring. These assessments are designed to provide information on a person’s symptoms, their progress and impact on daily life. The app has been developed in consultation with Max Little, a pioneer in PD app development who is best known for his work on the Parkinson’s Voice Initiative. Max is Assistant Professor at Aston University and is associated with Oxford University and the MIT Media Lab. The project has also been presented to the Michael J. Fox Foundation for Parkinson’s Research.

A series of Roche activities

“The data collected will be used to predict patient UPDRS scores and study symptom fluctuations throughout the duration of the trial. In addition, patient adherence data will be used to assess the patient’s willingness to adopt technology which will be beneficial for future trials,” says Christian Czech, Group Leader in Neuroscience Biomarker Experimental Medicine, pRED.

The active tests will ask patients to do a series of 30-second long activities. These include:

  • Voice test: conducting an “aaah” sound for as long as possible
  • Balance test: standing still
  • Gait test: walking 20 yards, including an 180 degree turn
  • Dexterity test: tapping two buttons alternately on the touchscreen with the dominant use hand
  • Rest tremor test: holding the smartphone in the hand most affected by the tremor, resting it on the lap and counting back from 100
  • Postural tremor test: holding the smartphone in the same hand, outstretched

For passive monitoring, patients are asked to carry the smartphone with them throughout the day. Data is then collected from the various smartphone sensors. Patients will be asked to use the app for the duration of the trial, including screening, dosing and follow-up, which may last up to a period of about 32 weeks.

Key role of investigators

The app is equipped with dashboards that show the patient’s compliance level. Based on this information, investigators can guide patients to use the app more regularly. Additionally, we can also monitor how much data is coming in from the smartphones. Based on this, we can ask investigators to speak with patients who should be using the app more regularly,” points out Christian Gossens, Head of Early Development Workflows, pRED Informatics.

The app has been developed for Android and it has been deployed to the trial on a Samsung Galaxy S3 Mini. Roche provides patients with dedicated, preconfigured smartphones for the sole purpose of remote patient monitoring via the app. This makes the device and the app easier to use for the elderly patient population.

Speaking about the project, Max Little said, “It was clear that Roche had the vision to recognise the value and potential of this technology, and the resources to make this a reality. It has been an exciting experience to see the concept take shape over the last couple of years.”

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Patient Home Care Monitoring Will Revolutionize the Health sector in 2016

Real-time health care monitoring including the patient’s home continues to gain importance as pressures come from a variety of sources to reduce risks and costs of readmissions and hospitalizations.

The Centers for the Medicare and Medicaid Services (CMS), enforcing the 2012 Medicare Readmission Reduction Program, the States and managed organizations have to deal with tighter budgets, rising costs of service, and stricter capitation rates.

Until recently, homecare reporting was archaic at best. The home was a “black box” where no information was generated when a home aide entered the residence and closed the door. Well-intentioned aides and nurses visited a patient’s home, administered and documented their visit in piles of paperwork that were often not reviewed or actionable.

Data input was first “modernized” to record home aide hours and minimal data about care by telephone. Such systems are used primarily for time and attendance. Aides visit the patient’s homes and use the patient’s home phone to document that their work shift has started. When the shift ends (and only when the shift is over), the home aide dials the phone to report the end of their shift, and with all the limitations inherent in pressing numbers on a dial pad, report that they had administered a few elements of care. Since they cannot see the output of what they entered, such data entry is error prone and of limited value.

To move home health care forward and to reduce costs requires a new approach. Forward thinking home aide agencies, health care providers, managed care organizations and hospitals are looking for innovative solutions that leverage the proliferation of tablets, smartphones and the ubiquitous Cloud to improve care at home, where patients spend most of their lives and where so many significant health events occur.

Thanks to technology, the “black box” of healthcare monitoring can be transformed into a sea of data where home health aides can gather 500-1,000 data points per month. The real-time collection and utilization of data from the home will offer these ten key benefits for specific patient populations, their families and every member of the patient’s care team in 2016.

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December 2, 2015 / Posted by / Patient Home Care Monitoring Will Revolutionize the Health sector in 2016