Trends beyond the new normal: from remote monitoring to digital connectivity

Heart failure and telemedicine: where are we and where are we going? Opportunities and critical issues

Heart failure (HF) is one of the main causes of morbidity in the world and is responsible for an enormous amount of health costs, mostly due to hospitalizations. The remote control techniques of vital signs and health status have the potential to help prevent factors leading to HF instability by stimulating early therapeutic interventions. The goal of telemedicine is to change the intervention strategy from a 'reactive' type, in which therapy is optimized in response to the worsening of symptoms, to a 'pro-active' type, in which therapeutic changes are undertaken based on changes in the monitored parameters during the sub-clinical phase. This article is aimed at exploring the major results obtained by telemedicine application in HF patients with and without cardiac electronic devices or in those with haemodynamic sensors and to analyse the critical issues and the opportunities of its use.

Multi index evaluation method of pathological weight loss effect of aerobic exercise based on telemedicine monitoring

INTRODUCTION: Pathological obesity seriously endangers human health. OBJECTIVES: A multi index evaluation method of pathological weight loss effect of aerobic exercise based on telemedicine monitoring is proposed to evaluate the pathological weight loss effect of aerobic exercise by using telemedicine monitoring system. METHODS: According to the indexes of aerobic exercise affecting weight loss effect, a multi index evaluation system of pathological weight loss effect of aerobic exercise was established. The medical sensor of the telemedicine monitoring system is used to collect the index data in the multi index evaluation system of pathological obese personnel. The medical sensor uses the wireless node to transmit the collected data to the remote monitoring center. The evaluation module of the remote monitoring center uses the collected data and selects the fuzzy comprehensive evaluation method to evaluate the pathological weight loss effect of aerobic exercise. RESULTS: The experimental results show that this method can effectively use the telemedicine monitoring system to collect the physiological parameters of pathological obese people, and use the parameter collection results to evaluate the effect of aerobic exercise on pathological weight loss. CONCLUSION: The proposed methods can provide basis for human aerobic exercise pathological weight loss.

A remote consultation system for sports injury based on wireless sensor network

INTRODUCTION: Although current research methods can realize the effective collection of human physiological signals in the health monitoring system, they cannot obtain the ideal detection effect due to the influence of the communication performance in the health monitoring system. OBJECTIVES: In order to improve the monitoring performance of remote consultation, a sports injury remote consultation system based on wireless sensor network is designed. METHODS: The wearable sensors is used in the body area network to collect human physiological signals. Through the wireless sensor network of the wireless communication module, the collected human physiological signals are transmitted to the remote consultation module. The wireless communication module selects CC2530 chip as the core chip of the wireless communication module. A fixed partition routing algorithm based on energy balance is used to stably transmit human physiological signals. RESULTS: The consultation personnel of the remote consultation module make a sports injury consultation judgment based on the received physiological signal results of the human body. The system test results show that the designed system can accurately monitor various physiological indicators of the human body. The wireless sensor network energy consumption of the system in this paper is all less than 500J, the energy consumption variance of the cluster head is less than 4×10-3, and the number of surviving nodes can be guaranteed to be higher than 130. It has high communication performance of wireless sensor network. CONCLUSION: The system can accurately judge whether there is a sports injury according to the monitoring results of physiological indicators, and realize the effective consultation of sports injury.

Toward digital transformation in healthcare: a framework for remote monitoring adoption

Purpose

Digital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization – particularly of the Internet of Things (IoT) – on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation.

Design/methodology/approach

The authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports).

Findings

According to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management.

Research limitations/implications

The authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis.

Practical implications

The paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions.

Social implications

RM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus.

Originality/value

The study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients.