J. Artur Serrano, Halgeir Holthe, "Development and trial of ePoint.telemed" at MIE2015

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Development and trial of ePoint.telemedAn open web-based platform for home

monitoring of chronic heart faillure patients

J. Artur Serrano and Halgeir Holthe

University Hospital of North Norway

©2015 J. Artur Serrano

University Hospital of North Norway - Tromsø

CHF Home Telemonitoring

• Randomized controlled trial• Funding: Norwegian Health Ministry• Partners:• University Hospital of North Norway• NST Norwegian Centre for Integrated Care and Telemedicine• Heart Policlinic. Responsible - Ragnhild Jonassen (nurse)

• Technology developed in collaboration with ePoint in Belgium

©2015 J. Artur Serrano

ePoint.telemed

Hospital Server

ePoint.telemed

CloudWi-Fi

Third party blood pressure meter

Third party weight scale ePoint.telemed

patient questionnaire

Hospital Dashboard

©2015 J. Artur Serrano

The project

• Providing patients with chronic heart failure (CHF) access to remote monitoring reduces deaths and hospitalizations and may provide benefits on health care costs and quality of life (Cochrane Systematic Review in 2010)• The service to be created in this project consists of daily monitoring the

patients’ weight and blood pressure directly from their home• Values are transmitted to a server at the hospital• A daily questionnaire allows the nurse to have an overview of the patient

condition.• Abnormal values are automatically detected and an email is sent to the nurse

responsible for the patient.• Enrolment has started – total 50 patients on trial.

©2015 J. Artur Serrano

Wearable technologies in the healthcare sector

Remote patient monitoring (RPM), also called homecare telehealth, is a type of ambulatory healthcare that allows a patient to use a mobile medical device to perform a routine test and send the test data to a healthcare professional in real-time.

[email protected] Coraggio - DLA Piper 6

©2015 J. Artur Serrano

The daily questionnaire

©2015 J. Artur Serrano

Main features and functionalities

• Web-based – platform independence• All private personal data is de-identified (only ID codes are used)• Easy-to-use personal health system (PHS) components geared towards the sports and wellness market• Only Wi-Fi used as wireless technology• Open API’s • Two different strategies for component integration are implemented in the platform. A) Secure email parsing.

• Based on REST API (REpresentational State Transfer Application Programming Interface) • Used with the BP3 blood pressure meter from iHealth

B) Oauth communication package. • Used with the Withings weight scale

• The system is open and easily configurable for other types of equipment.• The estimated effort for configuring a new device on the system is approximately one to two

person.days.©2015 J. Artur Serrano

ePoint.telemed

Hospital Server

ePoint.telemed

CloudWi-Fi

Third party blood pressure meter

Third party weight scale ePoint.telemed

patient questionnaire

Hospital Dashboard

©2015 J. Artur Serrano

Discussion

• Patient involvement – from a feasibility testing to the RCT• No pilot - the one patient trial (n-of-1 trial)• Inclusion of patients and distances• Openness• Data transfer is anonymous• Economical perspective• Equipment• Human resources (nurse time) – patient satisfaction – job satisfaction

©2015 J. Artur Serrano

Lessons learned and conclusions

• The importance of the questionnaire• Emails with alarms are the main feature for the nurses• Configurability per patient is a main factor for acceptance by the

nurses• Less is more – minimalistic equipment• Human involvement is vital – treatment follow-up side-by-side with

technical support

©2015 J. Artur Serrano

What’s next?

• Further openness possibilities are being evaluated• Further development of architectures (see VictoryaHome.eu)• Focusing on other conditions: diabetes and COPD• Focusing on tertiary prevention. For example integration with

motivational apps for healthy behaviours

©2015 J. Artur Serrano

J. Artur Serranoa,b and Halgeir Holthe a

[email protected]@telemed.no

a NST Norwegian Centre for Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway

b Telemedicine and eHealth Research Group, Faculty of Health Sciences, UiT Arctic University of Norway

©2015 J. Artur Serrano

Acknowledgements: we acknowledge the funding from Helse Nord and the collaboration with the ePoint firm in developing the platform and in particular the help of Ronny Broekx, Project Manager.