Tanja Bratan

1
Optimum Design of Remote Patient Monitoring
Systems

• Tanja Bratan
• Malcolm Clarke
• BRiGHT - Brunel Research Group for Health
  Technologies
• School of Information Systems, Computing
  Mathematics
• Brunel University
• United Kingdom

2
Introduction

• Remote patient monitoring
• The electronic monitoring of physiological
  measurements of patients
• not confined to hospital, using information and
  communications
• technologies to transfer data over geographical
  distances.
• High quality care
• Effective use of healthcare resources
• But To date little integration into mainstream
  healthcare in the UK

3
Our work

• Identification of the typical set-up of RPM
  projects and services in the UK (Initially
  through published literature, then through
  interviews with staff from nine projects)
• Proposed solution for a clinically and
  organisationally more integrated service

4
Methodology

• Databases searched
• Foundation for Assistive Technology (FAST)
• UK Telemedicine and E-health Information Service
  (TEIS)
• Telemedicine Information Exchange (TIE)
• Integrating Community Equipment Services (ICES)
• European Information Society Technologies (IST)
• Peer-reviewed journals and databases
• Journal of Telemedicine and Telecare
• Telemedicine and e-Health Journal
• IEEE
• Medline
• Inspec

5
Methodology cntd

• 13 project identified
• Semi-structured one-to-one interviews with staff
  from nine current or recently ended projects
• Total of 20 interviews. Transcribed and analysed.

6
The projects

• Diseases
• 5 COPD, 2 CHF, 2 various long-term conditions, 2
  various unstable acute conditions (4 monitor more
  than one condition)
• Aims
• 5 reduction in hospital admissions, 2 early
  discharge, 1 improvement of management, 1
  assessment of benefits and feasibility (some
  overlap)

7
Findings

• 3 types for RPM service can be distinguished
• Based in primary care
• Based in secondary care
• Separate service, usually with links to both
  primary and secondary care

8
Patient pathway for long-term conditions
9
Patient pathway for RPM in primary care - current
10
Patient pathway for RPM in primary care - optimum
11
..and in secondary care - current
12
..and in secondary care - optimum
13
..as a separate service
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Roles in an RPM system - current
15
Roles in an RPM system - optimum
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Findings cntd.

• Monitoring of chronic disease patients best
  carried out in primary care
• Monitoring of patients with acute conditions
  recently discharged from hospital best carried
  out in secondary care
• Primary care not yet ready for RPM -gt separate
  service implementation interim solution

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Conclusion

• The purpose of the RPM determines where it is
  best implemented, although existing provision of
  care and skills and resources need to be
  considered.
• The better use an RPM system makes of existing
  pathways and collaborations, the greater its
  integration into the health care system.

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More information

• ? Tanja.Bratan_at_brunel.ac.uk
• Malcolm.Clarke_at_brunel.ac.uk
• Thank you!