“Remote Monitoring in Heart Failure: No Additional Benefit”

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mHealth Insights

The executives at Medical Device companies who have sat on their hands doing nothing to connect their devices or create interactive experiences will be cheerleading these results but we shouldn’t let them as this is exactly the type of discrediting that they need to keep getting away with failing Patients, raising the sale prices of their decrepit tech and maintaining barriers to market for new entrants who are taking innovative connected approaches: The failure to use data effectively doesn’t mean the data doesn’t have value.

Imagine what the BornMobile would think/say if Dr Martin R Cowie tried to explain the design of this study to them:

> What do you mean the Patients have no idea if the live saving medical device you have implanted in their body is switched on/off, is faulty, has a flat battery, has the latest patched software installed, etc?

> Why have you not even tried to connect the Patients in your race to get data from the devices?

> Why is your monitoring focused on these devices and not on your Patients?

> Why do you make these patients travel and do things every week when I can just press my phone and an Uber arrives?

> I’m surprised the Patients in your connected group didn’t have worse outcomes with all the extra unnecessary hassles your made them undertake as part of your study.

> Did this study pass your mother test eg. is this how you would care for a Patient who was also your Mother?

we could find no evidence of additional benefit from remote monitoring,” Dr Martin R Cowie (Imperial College London, Royal Brompton Hospital, UK) told conference attendees

If you are a clinician or researcher who is unable to find benefits from remote monitoring find someone to collaborate with who can. There are a lot of very senior people in organisations like the NHS who are bluffing about Big Data etc so you’ll probably need to kick some tyres before you’ll find someone good but check out the introductions to the mHealth group as there are some really smart professionals to be found there and via Linkedin you can check out their backgrounds/connections/work experiencee.

researchers found that remote monitoring did not reduce mortality or the number of cardiovascular hospitalizations compared with usual care”

I wonder why these researchers think every car manufacturer is following Tesla’s lead and embedding connectivity into their vehicles to deliver a modern ownership experience? Imagine how Elon Musk would be mocked if he said they were going to remove the embedded connectivity in Tesla cars because they made no difference to breakdown and crash rates and didn’t save Tesla engineers any time or money?

“Patients (mean age 70 years) had one of three types of CIEDs equipped for remote monitoring: a cardiac resynchronization therapy (CRT) device with pacemaker, a CRT device with defibrillator function, or an implantable cardioverter-defibrillator (ICD)… …Researchers analyzed automatically downloaded weekly data from patient devices and advised the patients about medication, lifestyle, the need for clinic visits, or other recommendations. Usual-care patients did not have automatic downloads but had usual remote monitoring every 3 to 6 months plus usual care for heart failure”

Were these Researchers also the Doctors who were caring for the Patient or do we have unfamiliar ‘researchers’ who have little/no medical training with clipboards as the value of these interactions will be very different.

Imagine the laughing stock if a car manufacturer tried to conduct research that was designed like this and presented it at a big auto industry meeting: a control group had to go to the garage receptionist every week to do a data dump and get some boiler plate advice about their driving style and the other group had to drive around in their car with all the dashboard lights/alerts disabled and turn up every 3/6 months.

“70% of the patients had additional actions taken by looking at the remote data”

Amazing that so little is made of this finding in the article. This sounds just like the type of data you might like to compare and contrast the devices that are being bought from different manufacturers at widely varying retail prices. This data seems like exactly the type of data needed to calculate value for money for the NHS.

Perhaps these Heart Failure researchers aren’t aware of the calls for connectivity to be embedded in medical devices by organisations like the International Diabetes Federation (millions of Patients with diabetes are already self managing medical devices and are benefiting from remote monitoring)? What do you think?

About David Doherty

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