Mobile Phone-Based Remote Patient Monitoring System for Management of Hyper tension in diabetic Patients - Essay Example

Introduction The report is a speech on the paper, ‘Mobile Phone-Based Remote Patient Monitoring System for Management of Hyper tension in diabetic Patients’ by Alexander G. Logan, Warren J. McIsaac, Andras Tisler, M. Jane Irvine, Allison Saunders, Andrea Dunai, Carlos A. Rizo, Denice S. Feig, Melinda Hamill, Mathieu Trudel, and Joseph A. Cafazzo. The aim of the paper: Over the years, doctors and physicians have voiced out their concerns regarding the poor level of blood pressure control in hypertensive patients. These concerns have prompted calls for novel ways of managing hyper tension. The paper revolves around the development of a BP-telemanagment system which involves patients in the care process. There are various health care aids available in the market. These can be easily used at home and are very convenient to handle. They are available in different forms and kinds. Their scope is varied and they range from simple home BP monitoring devices to established and sophisticated telemanagement systems. However the experiences with these home devices for controlling BP have not produced effective results. It has hardly been encouraging. The authors of the paper talk about the huge dearth of reliable home BP monitoring devices and the challenges of the internet especially for elder people which obstructed the adoption of these devices by physicians and patients. New solutions are needed. The aim of the paper is the development and pilot-testing of a mobile-based remote patient monitoring system to improve BP control of hypertensive patients with diabetes. Methods The system was developed in two phases. The first phase was an iterative process based on feedback from the users. In this phase there were a series of focus-group meetings with patients and primary care providers. The purpose of the meeting was to guide system’s development. In the second phase, a pilot study was undertaken to assess the system’s over all effectiveness in improving BP control of diabetic patients with hypertension, its over all acceptability to users and the reliability of the results. In the second phase, 33 diabetic patients who were also victims of uncontrolled ambulatory hyper tension were taken as samples. They were enrolled in a 4-month pilot study program. The pilot study used before-and-after design is to assess the effectiveness of lowering BP, its acceptability to users and the overall validity of its measurements. The system was developed through a commodity hardware. It comprised of a Bluetooth-enabled home BP monitor, a mobile phone for data transfer and a central server for data processing. The results showed that BP control improved immensely in the pilot study. Patients were pretty satisfied with the system and considered it to be very acceptable and effective. My opinion about the study: I feel this is a very well articulated study. The literature review was very comprehensive and the data sampling very apt. The study provides ground breaking rationale for the use of telemanagment system in improving hyper-tension. An important limitation of the study was the fact that it was restricted to patients of only a certain area. Results could have varied with people coming from different ethnic and cultural backgrounds because the level of hypertension would have varied. Thus, while research is extremely important and critical for embarking on new discoveries, perfect research is not possible. No matter how much we try in improving our research, there will always be some loop holes left that would impede the perfect nature of the research. Conclusion This was a very well conducted study. The people working on the study produced effective and encouraging results. The results place enough rationale on the table for long term clinical trial in determining If such a device can be used to improve BP control in the community amongst patients who are victims of uncontrolled hypertension. The new proposed tele-management device proved to be very effective for physicians in their endeavor to lower BP of their patients. Moreover it was universally accepted by patients and provided routinely and timely information to physicians. It did not disrupt their work flow unlike previous devices. It was hassle free and user needs were met without involving the use of the internet. In the earlier devices there was a lot of dependency on the internet which made it difficult for elderly people to understand and relate to it. Economically as well the device proved to be very lucrative. It uses inexpensive hardware and also eliminates the need of health care personnel to read BP. Both these measures greatly reduce the overall cost of the device. The system developed during this project can also be used for other purposes. It’s a very cost effective system and may set the ball rolling for other telemonitoring and tele management system. These systems could be used to check on blood glucose levels, oxygen saturation and body weight. The results of the study are very encouraging and provide enough rationale for taking up long-term randomized clinical trials. This BP tele-management system could be used to improve BP control in the community among patients with uncontrolled hypertension. . References: Clark NM: Management of chronic disease by patients. Annu Rev Public Health 2003;24:289 –313. Kaufman DR, Patel VL, Hilliman C, Morin PC, Pevzner J, Weinstock RS, Goland R, Shea S, Starren J: Usability in the real world: assessing medical information technologies in patients’ homes. J Biomed Informatics 2003;36:45– 60. .Pickering TG, Gerin W, Holland JK: Home blood pressure teletransmission for better diagnosis and treatment. Curr Hypertens Rep 1999;1:489–494. Read More