Transcript Home monitoring of patients with chronic heart failure

Department of Signals and Systems
Care @ Distance
Disease Management System for
CHF Patients
Anna Gund
PhD Student, Chalmers University of Technology
Gothenburg, Sweden
Bengt Arne Sjöqvist, Adj. Professor, Chalmers University of Technology
Kaj Lindecrantz, Professor, Borås University College, Borås, Sweden
Inger Ekman, Associate Professor, Sahlgrenska Akademin, Gothenburg University
Department of Signals and Systems
Overview
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Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Introduction
• Congestive Heart Failure
– 2% of western population
– Most over 60 years of age
– Chronic health disorder
• Amount of elderly increasing
• Growing expenses
• Shrinking resources
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Purpose of IT-based Home Care
• Improved care:
– Improved treatment compliance
– Better basic data for health related decisionmaking
– Faster detection of deteriorating health
– Easier to see effects of new/changed medication
– Patient can stay home for longer periods of time
• Cost Efficient:
– Fewer/shorter hospital visits
– Fewer acute situations
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Patient’s
Family
Network
Patient
Patient
Database
Care giver
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
System Overview
• Home client
– Placed at patient’s home
– Computer with installed software
– Physiological sensor equipment
• Web portal
– For care givers as well as patient with family
– Accessible through internet browser
• Infrastructure
– Broadband connection (UMTS)
– (Bluetooth between sensor and home client)
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Home Client
• Home equipment
– Easy to use
– Small intrusion on daily life
• Measurements
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Once or several times per day
Body weight
Blood pressure
Pulse
(Electric Bio-Impedance)
• Subjective questions
– Fatigue
– Dyspnoea
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Web Portal
• Accessible via web
browser
• Examine patient data
• Administrate:
– Patient data
– Equipment
– Questionnaires
• Create measurement
schedules
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Pre-trial
• Performed at Östra Hospital, Gothenburg Sweden, spring
2007
• Two parts: evaluation of home client and web portal
• Home Client
– Objective: evaluation of usability and design
– 10 patients, ages 62-87, 4 female 6 male, none to average
computer experience
– Tried system once in connection with appointment
– Evaluation through observations and questionnaire
• Web portal
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Introduction
Objective: re-design of web portal
Paper prototype
3 nurses at Östra Hospital
Evaluated through interviews
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Results
• Home client
– 8 out of 10 (80%) found the system easy or very easy
to use, 2 out of 10 (20%) found the system hard to use
– 6 out of 10 (60%) had difficulties pressing the touch
sensitive screen
– 5 out of 10 (50%) had some difficulties with numeric
keyboard
– Most problems can most likely be solved with better
instructions
– All patients could consider using the system on a daily
basis
– Larger and longer trials necessary
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Results cont’
• Web portal
– 2 out of 3 found the system intuitively easy to use,
the third thought if would take some time getting
used to
– Many comments of details of the pages, such as
names on buttons and which information should
be entered
– Greatest concern not of usability of system, but of
amount of information to be handled
– More tests needed to evaluate over longer periods
of time
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Current Work
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System verification
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Preparations for longer trials in home
environment
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Introduction
~3 patients
1-3 months
Improvements on current home client
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“De-bugging” using healthy volunteers
Web based system, master thesis recently
started
Development of new Web Portal
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Future Plans
• Apply EBI (Electric Bio-Impedance)
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ECG
Oedema
Respiration
Etc.
• Develop new sensor techniques
– Necessary in order to use EBI in home care
applications
– User friendly
– Non-invasive, pain free
– Wearable electronics / Smart textiles
• More tests and improvements
Introduction
Purpose of IT-based home care
System overview
Pre-trial
Current work
Future plans
Department of Signals and Systems
Thank you!