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USE OF MOBILE PHONE TECHNOLOGY TO IMPROVE OUTCOMES IN PATIENTS WITH CRITICAL LIMB ISCHEMIA AND DIABETES
A157.E1468 JACC Maarch 9, 2010 Volume 55, issue 10A
VASCULAR DISEASE USE OF MOBILE PHONE TECHNOLOGY TO IMPROVE OUTCOMES IN PATIENTS WITH CRITICAL LIMB ISCHEMIA AND DIABETES ACC Poster Contributions Georgia World Congress Center, Hall B5 Sunday, March 14, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Peripheral Arterial/Carotid Disease/Aortic Disease Abstract Category: Innovative Models for Practice, Education or Research Presentation Number: 1055-348 Authors: Jenny E. Freeman, Thomas L. Rosser, Matthew Brown, Thomas MJ Rosser, James F. Toy, IV, JEF Core, Inc., WESTON, MA Background: Mobile phone based tele-monitoring provides a new approach for collection, storage & review of patient data at point of care/ point of usage. An advanced system has been evaluated in patients with both diabetes & wounds. Timely transfer of information to physicians may facilitate ongoing patient assessment, improving management, timing of intervention & postoperative care in patients with critical limb ischemia (CLI). Methods: The system implemented is based on a thin application overlay, downloadable in seconds to most mobile phones. Step One: Physician establishes a patient’s interactive Electronic Medical Record (EMR) on a database server & sets individualized parameters (image collection frequency, temperature alert & target glucose levels). Step Two: Patient downloads monitoring software directly to phone, receives automated alerts to enter data using easy pull-down menus. Step Three: Entered data _temperature, blood glucose & insulin& wound images collected by phone or stand alone camera _ are automatically relayed to patient’s EMR. Results: Deployment of cell phone monitoring in Hurricane Katrina (500 patients) & the Asian Tsunami (2,500 patients) to patients & emergency staff with little user training demonstrated efficacy of mass downloads & real-time, two-way monitoring with transmission of images, glucose levels & vital signs for rapid triage, wound evaluation & management by remote medical centers. Also studied in Australian diabetics, over 290 patients with standard insulin or insulin pump therapy showed improvement in both compliance & HbA1c. Analysis of 60 type 1 diabetic subjects demonstrated that number of handset interactions (wks 16-32) correlated with: HbA1c at 32 wks (r = - 0.50, p = 0.009), Δ HbA1c 16 - 32 wks (r = - 0.40, p = 0.04) & time in target range for 32 wks CGM (r = 0.40, p = 0.04). Conclusion: Early data demonstrate feasibility of remote monitoring of wounds & diabetes management, supporting utility of a point of care/ in-home monitoring system for patients with CLI. Such data may help physicians individualize care & re-examine on an as-needed basis vs. a routine schedule, optimizing patient care, improving outcomes, reducing cost & decreasing amputations.
VASCULAR DISEASE USE OF MOBILE PHONE TECHNOLOGY TO IMPROVE OUTCOMES IN PATIENTS WITH CRITICAL LIMB ISCHEMIA AND DIABETES ACC Poster Contributions Georgia World Congress Center, Hall B5 Sunday, March 14, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Peripheral Arterial/Carotid Disease/Aortic Disease Abstract Category: Innovative Models for Practice, Education or Research Presentation Number: 1055-348 Authors: Jenny E. Freeman, Thomas L. Rosser, Matthew Brown, Thomas MJ Rosser, James F. Toy, IV, JEF Core, Inc., WESTON, MA Background: Mobile phone based tele-monitoring provides a new approach for collection, storage & review of patient data at point of care/ point of usage. An advanced system has been evaluated in patients with both diabetes & wounds. Timely transfer of information to physicians may facilitate ongoing patient assessment, improving management, timing of intervention & postoperative care in patients with critical limb ischemia (CLI). Methods: The system implemented is based on a thin application overlay, downloadable in seconds to most mobile phones. Step One: Physician establishes a patient’s interactive Electronic Medical Record (EMR) on a database server & sets individualized parameters (image collection frequency, temperature alert & target glucose levels). Step Two: Patient downloads monitoring software directly to phone, receives automated alerts to enter data using easy pull-down menus. Step Three: Entered data _temperature, blood glucose & insulin& wound images collected by phone or stand alone camera _ are automatically relayed to patient’s EMR. Results: Deployment of cell phone monitoring in Hurricane Katrina (500 patients) & the Asian Tsunami (2,500 patients) to patients & emergency staff with little user training demonstrated efficacy of mass downloads & real-time, two-way monitoring with transmission of images, glucose levels & vital signs for rapid triage, wound evaluation & management by remote medical centers. Also studied in Australian diabetics, over 290 patients with standard insulin or insulin pump therapy showed improvement in both compliance & HbA1c. Analysis of 60 type 1 diabetic subjects demonstrated that number of handset interactions (wks 16-32) correlated with: HbA1c at 32 wks (r = - 0.50, p = 0.009), Δ HbA1c 16 - 32 wks (r = - 0.40, p = 0.04) & time in target range for 32 wks CGM (r = 0.40, p = 0.04). Conclusion: Early data demonstrate feasibility of remote monitoring of wounds & diabetes management, supporting utility of a point of care/ in-home monitoring system for patients with CLI. Such data may help physicians individualize care & re-examine on an as-needed basis vs. a routine schedule, optimizing patient care, improving outcomes, reducing cost & decreasing amputations.