Remote monitoring of patients has improved the quality of life for many, writes Sylvia Thompson.
TELEMEDICINE - the vast and expanding interface between technology and medicine is now reaching Irish patients in their own homes.
While doctors have been in contact with one another electronically for some time and electronic patient records are standard in some countries, the brave new world of remote monitoring of patients is now only becoming a reality.
One such system which is gaining attention in Irish hospitals is the remote monitoring of patients with various forms of heart disease. For example, patients fitted with medical devices for heart failure or arrhythmias (when the heart beats irregularly and the patient is at risk of sudden cardiac death), can now send regular updates of their condition to their doctors via phone line or internet connections. For patients whose condition remains stable, this means they don't need to go as often for hospital check-ups.
"Many patients with implantable heart rhythm devices are over 65 and require regular check-ups. Trips to the hospital can be stressful, particularly if they have to travel long distances," says Dr Joe Galvin, consultant cardiologist at the Mater Hospital, Dublin. "This technology improves the quality of life for the patient while reducing the dependence on hospitals and outpatient departments."
About 60 patients in the Mater hospital are taking part in a remote monitoring pilot project. These patients include Louise Lynn (21), pictured above, who was fitted with an implantable defibrillator four years ago and last year linked up to a remote monitoring system. "This means that now I only have to go to the hospital for a check-up once a year instead of four times a year," says Lynn who spoke about her experience at an international press briefing at the medical device company, Medtronic, in Switzerland earlier this month.
One of the features of the remote monitoring system is an in-built alarm system which picks up on irregularities, alerting the patients to make contact with their doctors immediately.
"So far, we've had one problem with a lead to the medical device which was picked up earlier through the remote monitoring system," says Galvin. "In general, patients are happy with it and it means fewer doctor visits."
Another unique feature of the Medtronic remote monitoring system used in the Mater hospital project is that it monitors fluid build-up in the patient's lungs. Research has shown that a rise in fluid can start up to two weeks before an actual incidence of heart failure so this form of monitoring can also alert doctors to potential problems at an earlier stage.
It also means that if the patient needs to go to hospital, the doctor can provide the hospital with accurate information and an assessment of the problem.
Galvin hopes the six-month pilot project will show how the new technology can help staff review patients in less time than before. A study carried out in Belfast City Hospital found that staff saved up to nine days when following up patients via remote monitoring systems compared with in-clinic follow-ups.
Ray Conboy, cardiac physiologist at the Mater hospital, says the option for patients to come into the hospital remains. "We always give the patient the option to come into the hospital because a lot of the older patients still want that social contact. Remote monitoring is not for everyone."