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HIT - Heart Insufficiency Telemedicine

HIT HIT

Heart Insufficiency Telemedicine
National project
Start January 2012
Finish June 2013
www.regionh.dk


HIT is a 1½-year demonstration project under the Capital Region of Denmark, the regional healthcare provider for Copenhagen and North Zealand. The HIT project aims to demonstrate the use of telemedicine in the treatment of patients with newly diagnosed heart insufficiency. Three Chronic Heart Failure (CHF) clinics in the region cooperate with private commercial partners to establish and evaluate the use of telemedicine. The clinics are:
  • Herlev Hospital
  • Bornholms Hospital
  • Hvidovre Hospital
The project will evaluate at least 50 patients over a period of one year.

The HIT project originates from the work carried out in the Healthcare Innovation Lab (HIL) project.

Rationale
Telemedicine is expected to have a great potential for saving labour as well as the potential for helping, in particularly patients with chronic diseases, in a variety of areas such as patient empowerment, reduced travel and waiting time, etc. In alignment with both regional and national targets, more patients should in the future be offered telemonitoring services. Therefore, emphasis is now on heart telemedicine as one of the possible options for the future.

The purpose of the demonstration project is to create a basis for decisions in the Capital Region on an ICT solution to be extended into all nine CHF clinics in the region. The project will focus on the clinical and organizational effects of telemedicine including cooperation with general practitioners and local government for outpatient treatment. The demonstration project will also clarify the deployability of the demonstrated ICT services to other chronic disease treatments. The basis for decisions made on the basis of a mini MTV (medical-technological assessment).  

Architecture
The patients receive the monitoring equipment (see Figure 1) in their homes and are asked to measure weight, pulse and blood pressure every morning.
HIT
Figure 1 The HIT data collection frontend

The clinics’ nurses responsible for medication dose titration (upgrade) monitor the measured data every forthnight in preparation for a video consultation with the patient. Measurements and video consultations replace a large number of the patient's physical examinations at the clinic.

Technology
Weight and heart rate / blood pressure data are automatially transmitted via Bluetooth to avoid incorrect manual ntries. The patient verifies and approves the measurements before they are transmitted to an IBM backend HIT application. This further mitigates the transmission of erroneous data.

When changing the medication, an updated medication list from the EPM (electronic patient medication modules) is produced and the nurse can discuss with and show the patient his/her data and the new medication dose via video conference. The updated medication list is subsequently sent via the HIT application.

The HIT application is further integrated with LABKA system in order to receive blood test results and with master data from GS Open EPR system. The patient uses the national digital signature NemID to log on to the web-based HIT application where they can see their own measured data and provide comments for the nurses.

Expected Project Outcomes
The main outcomes of the project are:
  • An integrated Telemonitoring platform for patients with heart diseases.
  • A carer application that integrate relevant data in a single user interface.
  • Evaluation of organisational effectiveness from the telemonitoring platform.
  • Evaluation of users satisfaction with the telemonitoring solution.
In-JeT is the device integration partner providing the LinkWatch data collection platform to the project. We develop the user interface for the patient and the web service interfaces to IBM WebSphere Sensor Event Server. We also establish the video conferencing link to the patient.

Partners
Region Hovedstaden (Capital Region), Denmark (Coordinator)
The CHF Outpatient Clinic at Herlev Hospital
The CHF Outpatient Clinic at Bornholm Hospital
The CHF Outpatient Clinic at Hvidovre Hospital
IBM Danmark, Denmark
In-JeT ApS, Denmark
T26 Technology A/S, Denmark
Post Danmark A/S, Denmark

Funding
Funded by the The Capital Region Programme on Chronic Diseases subsection 13b Telemedicine.
http://www.regionh.dk/kronikerprogram/menu/"

Project funding: 4.6 mDKK

Project start date: 1 January 2012 
Project end date: 30 June 2013 (extended)
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