Development and implementation in clinical practice of remote monitoring tools

Remote monitoring improves the efficiency of honey. service. 

The current level of development of Internet – communications and mobile communications opens up new directions for improving the efficiency of work in various areas of medicine. One of the promising approaches to improving medical care is to use 24-hour on-line monitoring systems remotely to monitor the condition of certain categories of priority patients. In this case, the patient and the specialized medical service are located at a distance of several hundred meters to thousands of kilometers. 

Using remote monitoring tools and remote patient monitoring solutions, the medical institution monitors the condition of the patient/s around the clock at any given time with the possibility of their analysis and registration in its database, which allows you to quickly make a decision on the provision of medical care. A medical organization that owns remote monitoring technology receives undeniable advantages in increasing the efficiency of its work, expanding the range of services for patients requiring medical support outside the hospital, monitoring seriously ill patients in intensive care units, intensive care units, and emergency departments of medical institutions.

Relevance

In everyday clinical practice, there are tasks associated with monitoring the condition of patients that require round-the-clock continuous monitoring. These patients include patients in the postoperative period, with severe injuries, progressive complications, who are under observation at home. As a rule, the assessment of their condition is performed by a group of electrophysiological parameters (EEG, ECG, respiration, pulse, pressure, …) and is reduced to a visual analysis of the dynamics of changes in parameters over a certain period of time. If the patient, due to circumstances, cannot be moved and is outside the medical facility, then remote monitoring of his condition and prompt decision-making becomes relevant. At the same time, all remote monitoring data is stored in the database and is always available to specialists for analysis and preparation of a conclusion.

Functions

The task of the remote monitoring system is to transfer all streams of data recorded from a patient (a group of patients) over a considerable distance without loss of quality and synchronism in real time. Such a transfer should be implemented for a long time with the provision of an information picture of the patient’s condition to the relevant services of the medical institution. In all cases, the monitoring system performs continuous registration, remote transmission, processing and display to medical personnel of a complete set of electrophysiological parameters of the patient’s condition on a synchronized time scale. Monitoring is performed around the clock in real time with support for various formats for the presentation of diagnostic information. 

All data streams are targeted and output to the terminals of the organization’s specialized services or the means of mobile communication of medical personnel. The remote monitoring system performs the integration of the patient’s electrophysiological characteristics to form a generalized assessment of his condition. Registered patient indicators can be relayed by the leading medical organization to specialized medical institutions or to several services of one institution for organizing joint research and decision-making. 

Thus, the relevance of the task of remote monitoring and the availability of modern advanced communication tools, their availability and prevalence are prerequisites for the development and implementation of new remote diagnostic tools in medical practice. The remote monitoring system performs the integration of the patient’s electrophysiological characteristics to form a generalized assessment of his condition. Registered patient indicators can be relayed by the leading medical organization to specialized medical institutions or to several services of one institution for organizing joint research and decision-making. Thus, the relevance of the task of remote monitoring and the availability of modern advanced communication tools, their availability and prevalence are prerequisites for the development and implementation of new remote diagnostic tools in medical practice. 

The remote monitoring system performs the integration of the patient’s electrophysiological characteristics to form a generalized assessment of his condition. Registered patient indicators can be relayed by the leading medical organization to specialized medical institutions or to several services of one institution for organizing joint research and decision-making. Thus, the relevance of the task of remote monitoring and the availability of modern advanced communication tools, their availability and prevalence are prerequisites for the development and implementation of new remote diagnostic tools in medical practice. Registered patient indicators can be relayed by the leading medical organization to specialized medical institutions or to several services of one institution for organizing joint research and decision-making. 

Thus, the relevance of the task of remote monitoring and the availability of modern advanced communication tools, their availability and prevalence are prerequisites for the development and implementation of new remote diagnostic tools in medical practice. Registered patient indicators can be relayed by the leading medical organization to specialized medical institutions or to several services of one institution for organizing joint research and decision-making. Thus, the relevance of the task of remote monitoring and the availability of modern advanced communication tools, their availability and prevalence are prerequisites for the development and implementation of new remote diagnostic tools in medical practice.

Differences and advantages

Combining the advantages of existing telemedicine and telemetry systems, remote monitoring has advantages that allow synthesizing an “information portrait” of a patient (group of patients) in real time, without being tied to his physical location. This provides the following unique features:

1. Low cost of operation. It is achieved through the use by the services of a medical organization of public means of broadband Internet communication of an economy class in various modifications: wireless, dial-up, dedicated, etc. 

2. High speed data transfer. Real high-speed broadband Internet traffic reaches 100 Mb/s, which will ensure the collection and stable transmission of electrophysiological indicators of the patient/s condition to specialized services of the medical institution in real time.

3. Combination of indicators. The medical institution simultaneously receives data streams on the status of several patients at once. The recorded data goes through three levels of integration. The first level combines data from electrophysiological equipment for each patient, the second level combines data from several patients, and at the third level, data from several medical facilities where patients are accommodated. For the integration of medical information flows, hardware and software tools that have been tested in solving similar problems of remote communication are used.

4. Maintenance of the monitoring database. All data streams entering the organization via remote communication are automatically stored in the medical database and are strictly associated with the medical records of the observed patients. This allows specialists to implement a post-processor analysis of the registered information with the possibility of printing, archiving and exporting to external media. Thus, for each “remote” patient, the doctor will always have access to the full amount of native information about the dynamics of changes in the patient’s indicators over the entire observation period.

5. Developed service for on-line analysis of input information flows. In the process of monitoring remote patients, specialists are provided with the ability to comment (text, audio recording of the doctor’s voice) on the recorded information at any time, perform operational printouts of individual sections of the recording, implement specialized data processing operations, and a number of other features that increase the efficiency of on-line analysis. Consequently, the visual perception of the dynamics of electrophysiological parameters is complemented by a wide functional service for its processing.

6. Continuous, round the clock monitoring. The patient’s condition is recorded as a set of electrophysiological parameters with a digitization frequency of at least 100 Hz. The total flow of information while monitoring 15 patients is up to 1 Mb/sec. All data is received around the clock on the Internet gateways of the medical organization and distributed by departments, displayed on terminals for operational analysis.

7. Synchronization of all threads in real time. All data streams registered from “remote” patients in real time are strictly synchronized. All events are recorded in the system memory automatically and are commented by specialists in on-line mode. This approach allows to obtain a qualitative assessment of the clinical situation for each patient.