Remote patient monitoring to improve patient care
Cardiology Technological innovations within the last 10-20 years have rapidly changed the way heart failure is diagnosed, treated and monitored in the UK and more developments are on the horizon.
At present, more than 800,000 people in the UK are living with heart failure. In addition to the physical symptoms of this debilitating and potentially life-threatening disease, patients have to endure the added anxiety of regular hospital visits. It’s costly, stressful and time consuming for staff, patients and caregivers, so advances in home-based care can offer a more efficient and effective solution for everyone.
“With specialist community services, heart failure nurses and recent developments in monitoring, the UK is at the forefront of delivering world standard care for heart failure patients,” explains Professor Martin Cowie.
At present, a very simple system of home-based care is being trialed by Professor Cowie and his team to reduce the number of unnecessary trips that patients have to make to hospital. Armed with a blood pressure cuff and weighing scales, patients can record their details on a daily basis and upload them for specialist nurses to monitor. As long as these results remain stable, patients need not travel unnecessarily to the hospital, but the moment there is a concerning change, doctors can respond immediately.
More recently, pioneering technology has seen capabilities taken to new levels with the development of a piece of electric crystal (small sensors) that can be implanted into the pulmonary artery (PA) through keyhole surgery. The crystal, which has no battery and can stay in the patient forever, is activated by radio frequency (RF) energy through the antennae in a pillow the patient lays on to take a reading each day. The reading of the patient’s PA pressure is then sent remotely to the patient’s care team for the physician to review. When the physician notices a meaningful change in PA pressure, the medical team can respond by contacting the patient and appropriately adjusting medications. Advancements in medical device innovation, through remote monitoring, are one of the leading tools to improving the quality of life with those with heart failure.
Preliminary tests in 550 patients in the US suggest that the device, can reduce hospital admissions by at least 30 per cent. Within the next 12 months a further study will be carried out in the UK with 50 patients receiving the implant as part of a trial at Royal Brompton Hospital. Cowie is hopeful that this could be the first step to more formal trials of the remote technology. “In five to ten years time, this may be seen as established practice for the right patients,” says Prof. Cowie. “We need to ensure it’s effective and provides value for everyone.”
With an ageing population, Cowie anticipates as many as one in four people are likely to develop heart failure during in their lifetime. Remote monitoring is part of a package of services that could dramatically improve the quality of life for these patients, whilst also helping reduce NHS costs in the long run. “With new technology there are always initial costs to be met,” says Cowie. “But costs always reduce over time. With rapid diagnosis, access to patient support groups and specialist nurses, there are lots of things around to help people get the best care. It’s important people know that the UK is at the forefront and if people aren’t getting the best care, they need to shout.”