Nene Remote Monitoring Proof of Concept

Vital signs are important indicators used in healthcare to inform a patient's treatment options and care plan. However, the opportunity to monitor vital signs is largely limited to the time a patient spends at a healthcare providers premises. This study is being conducted to see if the use of small wearable monitoring devices could help deliver a better service and improve patient care by continuing to monitor patients remotely.

The study is observational and has been designed to address two key questions:

• Is it possible in principle to use the information captured from the devices to improve the treatment of the patient?
• How practical is it to implement remote patient monitoring (RPM)?

To address these questions, consenting patients will be asked to wear a small adhesive biosensor for a short period of time following discharge from hospital (either as an outpatient or inpatient).

The data gathered by the device will be examined retrospectively and patients will not be monitored in real-time. Following the monitoring period, the vital signs data captured by the device will be analysed to see if it correlates with any unscheduled healthcare needs (such as unplanned GP appointments or emergency hospital visits). Specifically, the study team will be investigating whether the monitoring could have picked up a nascent problem before it became more serious, or whether monitoring could have saved the patient from having to make a trip to see their GP.

Information regarding the practicalities of implementing RPM will be captured by monitoring compliance and through an exit interview with participating patients.

Inclusion criteria

• The participant is able to provide informed consent.
• The participant is able to comply with the English instructions for using a wearable device (e.g, follow simple instructions, able to answer the telephone, able to answer symptom questions, etc.).
• The participant may have been recently discharged from a hospital care setting (including emergency departments, ward and acute assessment units) to home (including a relative's home) or be currently admitted to a hospital care setting.
• The participant has a recent medical history that suggests there is a risk their health may deteriorate at home. In the first instance we will focus upon patients with at least one of the following conditions:
• Heart Failure (the patient being discharged),
• Arrhythmia (e.g. patient on the waitlist for a pacemaker)
• We will also consider patients with other conditions that present a risk of deterioration at home, for example: COPD, stable angina, liver failure, minor trauma, chronic kidney disease, stroke, hypertension, cancer ( e.g. recent surgery)

Exclusion criteria

• Patients that are clinically unstable (eg: respiratory distress, ongoing angina pectoris, sepsis, etc).
• Aphasia or other conditions that prevents the patient from adequately communicating with the researchers.
• Terminal diagnosis with life expectancy < 3 months.
• Ongoing renal dialysis, or other treatment that prevents the patient from being at home for extended periods.
• Dementia or uncontrolled psychiatric illness.
• Severe dermatitis or another skin disorder that prevents the patient from wearing a patch.
• Patient has a pacemaker or ICD
• Other inability, or unwillingness, to adequately co-operate with the RPM-team.