mokaal / mhealth


Remote patient monitoring (RPM)

Remote patient monitoring (RPM) improved spectacularly the ability of healthcare professionals to monitor and manage their patients using nontraditional patterns. RPM uses digital technology to collect health data (i.e. vital signs) from individuals in one location, such as a patient’s home or workplace and electronically transmit selected metadata to healthcare providers in a different location for assessment, recommendations, as well as actions to deal with the incident. More specifically, noninvasive technologies are now commonly being integrated into disease management strategies to provide additional patient information, with the goal of improving healthcare decision-making. Digital technology is is increasingly being adopted as an additional method for healthcare systems to increase patient contact and augment the practice of preventive medicine.

The concept of telemedicine has changed from “medicine practiced at a distance” to “personalized ubiquitous healthcare on the move” under the health IoT. The trend in the mhealth sector, is towards noninvasive unobtrusive, wearable devices that capture automatically and transmit in real-time, vital signs without any action from the patient – bearer of the device. These devices are in the core of the wireless body area network (WBAN) complex, which is a IoT network that offers the prospect of the early detection of abnormal health conditions, real-time healthcare monitoring and remote telemedicine support systems.

The RPM systems introduce various methods in monitoring a patient using a computerized algorithms which operate within a health parameter monitoring system. Such a method usually comprises setting-up one or more personalized health parameter templates for the bearer of the RPM device, wherein these templates comprise data characterizing a physiological parameter of the bearer. Using the aforementioned algorithms, the system compares the bearer’s monitored vital signs to his/her personalized templates, in determining whether the bearer’s monitored health data are outside of an acceptable range in comparison to his/her personalized templates. These templates may be related to times of a day or to an activity level of the bearer and, under certain circumstances, may be automatically generated by the health monitoring system. In such a case, the system classifies the bearer’s monitored health data as abnormal and concurrently issues an alert, warning that this particular bearer has possibly experienced a health event. This alert initiates an emergency procedure that mobilizes all involving “actors” to directly address the incident.

It is generally accepted that the importance of the remote health monitoring systems and in particular, the out-of-hospital monitoring systems, is constantly increasing. Remote health parameter monitoring of ambulatory patients, enables doctors to detect or diagnose health problems, such as heart arrhythmias, that may produce only transient symptoms and therefore may not be evident when the patients visit the doctors’ offices. In this context, MOKAAL has developed the Integrated Facilitation Services for Remote Patient Monitoring system (IFS_RPM) which is an integrated tool that has been designed to support seamlessly and end-to-end the operations of any RPM establishment.

The principal components of IFS_RPM are :

  • The Wireless Body Area Network (WBAN) of the bearer that comprises the unobtrusive RPM device and its “body patches”, as well as a smartphone which is used as a pre-processor of the vital signs collected by the RPM device and as a router (3G/4G or Wi-Fi) for the transmission of the pre-processed data to the Central IFS_RPM System
  • The Central IFS_RPM System which hosts the IFS_RPM apps, the EHR (Electronic Health Records) of the bearers and the associated data bases, implements all the algorithms for the post-processing of the pre-processed vital signs, activates and administers the alert mechanisms and manages all the resources of the RPM network
  • The IFS_RPM telecoms network which interconnects the RPM “actors” with the Central IFS_RPM System and the RPM terminals (i.e. the WBANs), as well as to each other
  • The Incident Management Points

The main “actors” of the IFS_RPM complex, are :

  • The Bearer. Is the subscriber of the RPM for as long as she/he wears the RPM device and uses the IFS_RPM services
  • The Caregiver of the bearer. An authorized person who is receiving real-time update for any health event that occurred to the bearer, either directly from the IFS_RPM alert system or through the IFS_RPM Help Desk
  • The personal doctor of the bearer (optionally)
  • The coordinating physicians. A group of highly experienced doctors that coordinate and, if necessary, consult the on-duty doctors
  • One or more groups of on-duty doctors. They staffing the Incident Management Points and they work in 24X7 shifts, in interactive mode with the Central IFS_RPM System
  • One or more groups of on-duty nurses, also working in 24X7 shifts, in interactive mode with the Incident Management Points
  • The system Administrator – available on a 24X7 basis
  • The technical staff and the support staff
  • The Help Desk. Manages all, non-medical type, incoming messages and dispatches all outgoing messages to the technical and the support staff, the caregivers, etc.