Science & Technology in Action

12th Edition

Remote patient monitoring

Boston Scientific

The quality of life of patients with long term or chronic conditions is generally much greater if they can stay in their own home. They maintain contact more easily with family and friends and have a greater degree of freedom. With the benefit of RPM (remote patient monitoring) it is possible to quickly advise the patient or family members on what action to take if a problem arises.
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Contains the full lesson along with a supporting toolkit, including teachers’ notes.

Lesson excerpt

Introduction
The rapid growth in communications technology has made remote patient monitoring (RPM) much easier to implement. Sensors on the patient’s body can measure variables such as temperature and heart rate. The sensors can be linked to a portable processing device or to a mobile phone and the readings transmitted via WiFi or a mobile phone network to a remote server in a hospital or monitoring centre. The server stores the readings and can alert medical personnel when unexpected readings are obtained.

In this way patients who do not need constant medical care can be monitored in their own home. This frees up hospital beds and decreases the overall healthcare costs. However, despite all that can be done, the implementation of RPM is still in its infancy.

Patients with chronic conditions
The quality of life of patients with long term or chronic conditions is generally much greater if they can stay in their own home rather than in hospital. They maintain contact more easily with family and friends and have a greater degree of freedom. With the benefi t of RPM (remote patient monitoring) it is possible to quickly advise the patient or family members on what action to take if a problem arises. So, rather than the delay and inconvenience involved in getting to A&E (Accident and Emergency) and waiting in line for attention, normality can be restored in an effective and timely manner. Even if hospitalisation is required, the earlier action is likely to reduce the length of stay and to speed recovery.

Another benefit of RPM is that patients learn to anticipate problems and take preventive measures. This gives them more control of their situation, while knowing that help and advice are on hand when needed.

What does RPM involve?
For RPM to become a reality the following are required:

  • RPM infrastructure at a hospital/medical centre with monitoring equipment, secure data storage, up-to-date RPM software etc.
  • medical personnel with a wide range of skill in remote monitoring of patients, diagnosing problems and responding with appropriate action or advice
  • a reliable communications infrastructure — Internet or mobile phone — with sufficient bandwidth to cope with the extra data involved in RPM and video phone calls and conferencing
  • patients and GPs (General Practitioners) willing to use RPM.

There also needs to be a clear benefi t in terms of improved patient care without excessive cost and preferably with no extra cost.

True or False?

  1. Temperature cannot be measured remotely. false
  2. A sensor is a device used to detect some change and produce an appropriate output. true
  3. A chronic condition is one that is easily cured. false
  4. Remote patient monitoring requires very little infrastructure. false
  5. A voltage divider can be made with just two resistors. true
  6. An analogue to digital converter (ADC) is use to transmit data to a wireless network. false
  7. An electrocardiograph records the voltages associated with the cardiac cycle. true
  8. An accelerometer can be used as a fall detector. true
  9. Microcontrollers are programmable and many have built-in analogue-to-digital converters (ADCs). true
  10. Some contact lenses contain blood sugar sensors. true

Glossary of terms

accelerometer
a device that measures acceleration
analogue to digital converter (ADC)
a circuit that produces a digital value of an analogue signal
analogue voltage
a voltage whose value is proportional to some variable
contact lens
a lens that is worn in contact with the cornea of the eye
ECG
electrocardiograph - a recording of the electrical activity of the hear
remote patient monitoring (RPM)
monitoring a patient's condition from a remote location
silicon diode
a device, made largely of silicon, that conducts electricity in one direction only
telehealth
the provision of health services from a distant location
wireless sensor
a sensor that transmits measured values by radio
voltage
(or potential difference); a measure of electrical 'pressure' or the energy per unit electric charge relative to an arbitrary zero level
diabetes
a disease in which the body does not produce or properly use insulin, a hormone that is necessary to convert sugar, starches, and other food into energy
variable
a quantity or measurable property whose value is not fixed
Bluetooth
a wireless protocol used for personal area networks (PANs); it is used to facilitate communication between PDAs, mobile phones, laptops, PCs, printers, digital cameras etc.
integrated circuit
an electronic circuit in which the components are not individually packaged but are encased together in a single package
microcontroller
Computer on a single integrated circuit
sensor
device that measures or detects a physical condition, such as motion, heat or light and outputs the measurement as an analogue or digital
resistor
electrical device that can be used to limit an electric current
chronic
persistent or long lasting
voltage divider
potential divider, resistors connected in series across a voltage source
intermittent
stopping and starting at irregular intervals
absolute temperature
temperature measured in kelvins (K); temperature measured from absolute zero (0 K or -273.16°C)
bandwidth
the numerical difference between the upper and lower frequencies of a signal
cardiac cycle
the repeating sequence of steps by which the heart pumps blood
infrastructure
the set of interconnected structural elements that provide the framework for the entire structure.