Medtech gets the go-ahead for CHF home monitoring
A proposal by technology vendor Medtech Global and Peninsula Health in association with the CSIRO to trial remote monitoring of patients with chronic heart failure in their homes has been selected to receive full funding as part of the Victorian government's Health Market Validation Program (Health MVP).
The project was one of 12 feasibility studies conducted last year and put forward for the $15 million Health MPV, which aims to partner Victorian health agencies with innovative small to medium enterprises to improve health service delivery by developing new, market-ready technology.
The chronic heart failure model of care project was one of four selected to go into a full trial. It will involve 300 patients, half of whom will receive standard care and the other half using Medtech's VitelMed software on their mobile phones or devices to automatically track their weight and activity levels.
Weight measurements are collected from a Bluetooth-enabled scale and sent to Medtech's cloud-based ManageMyHealth portal, to which clinicians have access. The trial is also using Medtech's MD Analyze software to analyse the clinical data and improve treatment pathways.
The software includes prompts for the patients if they do not weigh themselves, and the ability for healthcare staff to contact them through VitelMed if they need to speak to the patient.
The project will use Peninsula Health's existing MEPACS personal alarm emergency response service if the patients are not weighing themselves to enhance compliance and improve adoption of the technology. The MEPACS service is offered to elderly and vulnerable people living at home in Victoria.
Peninsula Health CEO David Anderson said the trial would involve the existing chronic heart failure clinic, which is serviced by a team of cardiologists and cardiac nurses.
“The idea is that we will do a trial between the existing group and the existing services with the proposed service, which includes the scales, the daily measurements, the feedback back to the patient that says you've forgotten your measurements, as well as the clinical protocol,” Mr Anderson said.
“It is a clinical trial of around 18 months to hopefully identify hopefully both better outcomes and reduce costs using the technology.”
Mr Anderson said the project team had consulted with cardiologists on what measurements to track using the technology, and weight was the prime indicator. “A key part of the feasibility stage was for the cardiologists to say whether they wanted to collect a large number of data and it was concluded that the change in weight and activity were really the two key signs.”
The technology also has the ability to measure other indicators, including physical activity, and Medtech is working on the capability to add data from wearable devices such as Fitbits.
The rich audio video capability of mobile devices can also be used to better provide educational resources to patients in the months between scheduled visits to the cardiac clinic.
“Where the patient stays interested and engaged there is a better response, and we think daily weighing will enable a better response,” Mr Anderson said. “We can feed back some information and we can remind them if they haven't measured themselves, as well as getting earlier warnings about whether their weight has gone up or not.
“The other benefit will be that the care will be better streamed. If they only need to reduce their weight, they don't need to come in to a particular clinic, it will show if they need to get into a clinic sooner rather than later.”
Medtech's chief technology officer Rama Kumble said the trial aimed to use simple technology that is easy for the patients to use.
“It is a piece of software that runs on tablets and mobile phones and it connects with the weight scale through Bluetooth,” Mr Kumble said. “The information is gathered automatically so the patient doesn't have to intervene; they just have to stand on the scale. It automatically gets transmitted and then securely stored in ManageMyHealth.
“The whole clinical group is then able to participate in analytical care of the patient. The ManageMyHealth data is analysed by our MDAnalyse, which is also being used in the Royal Children's Hospital, Macquarie University Hospital and many other research hospitals around the world to improve the treatment pathways based on good clean clinical data. The data will be used by the clinicians at Peninsula Health to do long-term research as well.”
Through ManageMyHealth, the clinical team and the staff at MEPACS will be able to monitor each patient individually. If the data indicates something unusual is happening with the patient, MEPACS staff can call them or video conference them through VitelMed.
The other major benefit of the system is to include active participation of patients’ GPs in the care plan. The integration with PCEHR will enable GPs to use their own desktop software or they can directly log on to ManageMyHealth portal.
Medtech has developed a dashboard for an easy view of the data that can be set for each individual patient, and an algorithm developed by CSIRO can inform them if the patient is in danger of moving from green to amber to red.
It will also allow regular questionnaires about how the patient is feeling, whether they have shortness of breath or airway constriction problems when they are sleeping.
Mr Anderson said it was clear that this sort of home monitoring could be used for other chronic illnesses such as diabetes and pulmonary diseases, but it was essential that services such as these are sustainable and cost effective. To that end, it is using relatively simple technology joined to existing services such as MEPACS.
The primary objective of the trial is to improve the compliance rate of daily weight monitoring, with secondary objectives such as mortality, hospital readmission, risk factor management, symptoms management, medication, and quality of life.
The three other successful projects in the Health MVP include the development of a bidirectional cannula that will allow full circulatory support to avoid the risk of complications to limbs during surgery, involving MTMM and Alfred Health; the development of a new preservation technique for donor organs using perfusion instead of ice storage (Perfusion Solutions and Alfred Health); and a plaque removal device for children and others who have difficulty using a toothbrush (APS Innovations and Dental Health Services).
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