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Purpose
We hypothesize that home monitoring and telehealth utilizing data from a mobile healthcare
application in conjunction with laboratory values and chest imaging, can replace an
outpatient appointment.
Methods
Our study is comprised of patients who have received a single or bilateral lung transplant
or a heart/lung transplant.Before our patients are discharged from their inpatient
stay after Transplantation, the application for home monitoring is installed on their
smart phone. This application was specifically designed for Lung Transplant Patients.
A blood pressure cuff and spirometer are provided and linked to their mobile device
using Bluetooth. A weighing scale is also provided which uses a cellular connection
to a secure cloud relaying data to the patient's phone and to EPIC. Additional data
including (e.g. temperature, pulse oximetry) are manually entered into the application.
Physical fitness (steps) is also monitored. The team who created the application enabled
the data to flow from the application to our electronic medical record. Alerts are
set for each piece of data and any abnormal value is sent to our team's EPIC in-basket
for further action.Patients who are compliant with their home monitoring are offered
telehealth. Patients are sent for laboratory testing and imaging the week of the appointment
close to their home.
Results
As of October 1, 2019, we have enrolled fifty patients in our home monitoring program.
Fourteen patients are now one - year post transplant. Twelve of these patients are
compliant with home monitoring. Eight of them have had telehealth visits throughout
the year with five receiving the majority of their care utilizing home monitoring
and telehealth. These visits occur bimonthly for the first three months after transplant
and then monthly for the first year.
Conclusion
Home monitoring and telehealth visits can replace outpatient visits in the first year
following lung transplantation. Patients find the devices easy to use and are satisfied
with the care they receive during their telehealth visits. Additionally, telehealth
improves patient quality of life by reducing visits to the medical center and avoiding
additional costs such as parking and time off work. It also limits pathogen exposure.
Long term use may enable early detection of rejection or infection.
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Article info
Identification
Copyright
© 2020 Published by Elsevier Inc.
