Andreas Triantafyllidis1, Carmelo Velardo2, Tracey Chantler3, Syed Ahmar Shah2, Chris Paton3, Reza Khorshidi3, Lionel Tarassenko2, Kazem Rahimi4. 1. Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK. Electronic address: andreas.triantafyllidis@eng.ox.ac.uk. 2. Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK. 3. George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 4. George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Abstract
BACKGROUND: Despite their potential for improving health outcomes, mobile-based home monitoring systems for heart failure have not yet been taken up widely by the patients and providers. OBJECTIVES: To design and iteratively move towards a personalised mobile health monitoring system for patients living with heart failure, according to their health care and usability needs. METHODS: We present an iterative approach to refining a remote health monitoring system that is based on interactions between different actors (patients, clinicians, social scientists and engineers) and supports the collection of quantitative and qualitative information about user experience and engagement. Patients were provided with tablet computers and commercially available sensing devices (a blood pressure monitor, a set of weighing scales, and a pulse oximeter) in order to complete physiological measurements at home, answer symptom-specific questionnaires, review their personal readings, view educational material on heart failure self-management, and communicate with their health professionals. The system supported unobtrusive remote software upgrades via an application distribution channel and the activation or deactivation of functional components by health professionals during run-time operation. We report early findings from the application of this approach in a cohort of 26 heart failure patients (mean age 72±15 years), their caregivers and healthcare professionals who participated in the SUPPORT-HF (Seamless User-centred Proactive Provision Of Risk-stratified Treatment for Heart Failure) study over a one-year study period (mean patient follow-up duration=270±62 days). RESULTS: The approach employed in this study led to several system upgrades dealing in particular with patient requirements for better communication with the development team and personalised self-monitoring interfaces. Engagement with the system was constantly high throughout the study and during the last week of the evaluation, 23 patients (88%) used the system at least once and 16 patients (62%) at least three times. CONCLUSIONS: Designers of future mobile-based home monitoring systems for heart failure and other chronic conditions could leverage the described approach as a means of meeting patients' needs during system use within the home environment and facilitating successful uptake.
BACKGROUND: Despite their potential for improving health outcomes, mobile-based home monitoring systems for heart failure have not yet been taken up widely by the patients and providers. OBJECTIVES: To design and iteratively move towards a personalised mobile health monitoring system for patients living with heart failure, according to their health care and usability needs. METHODS: We present an iterative approach to refining a remote health monitoring system that is based on interactions between different actors (patients, clinicians, social scientists and engineers) and supports the collection of quantitative and qualitative information about user experience and engagement. Patients were provided with tablet computers and commercially available sensing devices (a blood pressure monitor, a set of weighing scales, and a pulse oximeter) in order to complete physiological measurements at home, answer symptom-specific questionnaires, review their personal readings, view educational material on heart failure self-management, and communicate with their health professionals. The system supported unobtrusive remote software upgrades via an application distribution channel and the activation or deactivation of functional components by health professionals during run-time operation. We report early findings from the application of this approach in a cohort of 26 heart failurepatients (mean age 72±15 years), their caregivers and healthcare professionals who participated in the SUPPORT-HF (Seamless User-centred Proactive Provision Of Risk-stratified Treatment for Heart Failure) study over a one-year study period (mean patient follow-up duration=270±62 days). RESULTS: The approach employed in this study led to several system upgrades dealing in particular with patient requirements for better communication with the development team and personalised self-monitoring interfaces. Engagement with the system was constantly high throughout the study and during the last week of the evaluation, 23 patients (88%) used the system at least once and 16 patients (62%) at least three times. CONCLUSIONS: Designers of future mobile-based home monitoring systems for heart failure and other chronic conditions could leverage the described approach as a means of meeting patients' needs during system use within the home environment and facilitating successful uptake.
Authors: Trisha Greenhalgh; Joseph Wherton; Chrysanthi Papoutsi; Jennifer Lynch; Gemma Hughes; Christine A'Court; Susan Hinder; Nick Fahy; Rob Procter; Sara Shaw Journal: J Med Internet Res Date: 2017-11-01 Impact factor: 5.428
Authors: Kazem Rahimi; Carmelo Velardo; Andreas Triantafyllidis; Nathalie Conrad; Syed Ahmar Shah; Tracey Chantler; Hamid Mohseni; Emma Stoppani; Francesca Moore; Chris Paton; Connor A Emdin; Johanna Ernst; Lionel Tarassenko; Kazem Rahimi; Carmelo Velardo; Andreas Triantafyllidis; Nathalie Conrad; Syed Ahmar Shah; Tracey Chantler; Hamid Mohseni; Emma Stoppani; Francesca Moore; Chris Paton; Lionel Tarassenko; John Cleland; Felicity Emptage; Tracey Chantler; Andrew Farmer; Raymond Fitzpatrick; Richard Hobbs; Stephen MacMahon; Alan Perkins; Kazem Rahimi; Lionel Tarassenko; Paul Altmann; Badri Chandrasekaran; Connor A Emdin; Johanna Ernst; Paul Foley; Fred Hersch; Gholamreza Salimi-Khorshidi; Joanne Noble; Mark Woodward Journal: Eur Heart J Qual Care Clin Outcomes Date: 2015-11-01