Vital Signs, Remotely
Remote, ongoing monitoring of people with chronic conditions is one of the most vigorous and interesting areas of development in the healthcare industry. Because heart disease affects so many people, we chose remote monitoring of post-operative cardiac patients as the theme for our entry in the MetaDistretti project, an initiative sponsored by the Italian government to increase technology transfer among industries. Together with our development partners Flextronics, GFM Net, and the University Politecnico di Milano, we designed and tested personal eMonitors that gather and electronically transmit electrocardiogram (ECG) data from cardiac patients convalescing at home to health professionals at work.
This was our first foray into the emerging healthcare field of remote tele-monitoring.
After researching the trends and traditions in the Italian telemonitoring market, we saw promise in remote monitoring—specifically in the remote monitoring of cardiac patients.
The first order of business was to conduct one-on-one interviews with cardiologists, cardiology nurses, family doctors, and cardiology patients who had suffered an acute event such as heart bypass surgery. Our interviews yielded insights on interactions with the healthcare system, and a deep understanding of the emotional turmoil caused by heart surgery.
Making It Work
From our research, we recognized that a systemic approach was necessary for telemonitoring to be most beneficial, both in terms of medical outcomes and in giving patients a feeling of reassurance. The system needed to be designed so that it reliably gathered and transmitted data without incurring trouble and expense for the hospital. We took a comprehensive approach to the design of the service structure, the ways in which the patient, call center, and caregivers would interact with it.
Based on extensive prototyping and user testing, the design evolved to include several elements:
- The Smart Patch, which fits on a patient’s chest and looks like a large bandage, uses sensors to gather ECG, blood pressure, or blood oxygen data without the need to penetrate the skin.
- The wearable Device Node receives and stores data from the Smart Patch, then forwards it via Bluetooth to a smartphone, minimizing battery drain on the Patch.
- The smartphone receives, analyzes, and stores databefore forwarding it to the Health Center, an independent entity staffed with trained medical professionals.
- The Health Center stores data, which can then be available to health providers and family via a Web or smart phone interface.
Simple, Wearable, Reassuring
Being a novel technology used at a stressful time, we followed three main principles in designing the eMonitor: simple, wearable, and reassuring.
Using the system had to be simple, so patients would be comfortable with technology. Setting it up requires just one switch, has clear feedback about status, and allows alerting the Health Center staff in an emergency with a large red button. The Smart Patch needed to be unobtrusive, comfortable, and move naturally with the person’s body. Taken together, these designs created reassurance by giving people confidence in the system and peace of mind as the patient recovered from life-saving surgery.