- Medical Wearables
- Data Services
- RPM for Clinical Trials
Selecting the right medical wearables for remote patient monitoring can be confusing. Beyond technical features, here is a list of practical questions to consider.
Remote patient monitoring (RPM) is defined as the use of electronic devices and sensors in order to collect data regarding vitals of patients such as heart rate, SP02, or temperature. This allows the ability to more closely and continuously assess the overall health data for an individual or group of individuals.
Some examples of how people use remote patient monitoring include:
Some of the most common types of remote patient monitoring include blood pressure cuffs, pulse oximeters, ECGs or as an alternative to Holter Monitors, thermometers, glucose monitors and oximeters or SP02.
Telehealth describes any remote service or activity conducted by a healthcare business as a whole whereas remote patient monitoring is the specific monitoring of a set of vital signs for an individual or group of individuals. Remote patient monitoring is a type of telehealth solution.
Healthcare providers and hospitals are increasingly using remote patient monitoring for specific vital signs that help inform the path of treatment or monitor the status of a chronic condition. Hospitals have used remote patient monitoring including holter monitors, which were first created in 1965, for decades. The advent of new remote sensors and monitoring systems has allowed hospitals to gather more continuous data for different vital signs to inform individualized treatment plans and improve patient outcomes.
A virtual hospital is generally defined as a full-scale hospital that provides its services without a physical location. This requires the use of technologies to help provide patient data and the use of specialty clinics or centers in order to coordinate treatment, such as surgeries. Increasingly, the availability of remote patient monitoring devices has improved the ability of virtual hospitals to provide quality, ongoing support for their patients.
It can matter greatly. Patient adherence to protocols and instructions is one of the keys to ensuring successful remote monitoring.
If a device is not comfortable (size/weight), or is not easy to use by the patient themselves, it will not be used on a consistent basis.
Yes, if you want to access data remotely. If you just want to record data and access data retrospectively, then an offline recording device can work. But this also puts the burden on the patient to send or bring back the device to the clinic.
There are two ways you can access data from Vivalink's medical wearables: 1) directly from the device itself, or 2) via the cloud service. Vivalink offers a development kit that allows you to directly take control of the data either from mobile apps or through M2M cloud APIs.
In RPM or ambulatory situations, it is common for there to be network (e.g. bluetooth, internet) disruptions.
During network disruptions, data will not be successfully transmitted from the wearable device to the mobile app or cloud.
In these situations, it is important to use wearables that have on-board memory so that you don't lose data.
This depends on your expectation of “realtime”. In general, with a good end-to-end network connection and well designed application, data can be transmitted from wearables to the cloud within seconds, followed by a continuous stream of data.
Consider the various paths that the data needs to travel:
From wearable to mobile app - assuming you have a reliable connection (e.g. BLE), the timing may be 1 to 5 seconds on the initial transmission, then a continuous stream of data depending on the data type and sampling rate.
From mobile app to cloud - assuming you have a reliable internet connection, this delay is mainly dependent on the way the mobile app is designed. With a fast internet connection, the delay should be minimal.
There are two things to consider for patients who are mobile: 1) data accuracy, 2) device adherence.
The most common impact is signal quality. This depends on how much movement there is, the modality or location of the wearable, and the type of data you’re trying to capture. For example, ECG signals can be noisy with high activity. But if you just want heart rate, there are many devices which can measure an accurate heart rate even with movement.
The other issue has to do with whether the device will stay securely on the body. You’ll want to choose devices that won’t shift easily (which affects signal quality), and won’t fall off with movement. Also consider nighttime readings since some people move quite a bit during sleep.
Note also that with adhesives based devices, heavy sweat or humidity can affect how well it adheres to the body.
This depends on the type of wearable device. Wrist style devices can be worn as a daily lifestyle with little impact to comfort.
Adhesives based devices are designed for multi-day use, but not necessarily for non-stop everyday use over a long period of time due to potential irritation.
There are different types of adhesives, so understanding the duration and frequency of application is important in order to find the right match.
In most clinical situations you’ll need the proper clearances such as FDA, CE Mark or NMPA. For research, you may be able to use investigational devices.
But even with regulated devices, you want to check that the use case is well matched to the function.
Unregulated devices can run a higher risk of data accuracy, or even potential harm.