Abstract 12371: Automated Home Monitoring of Infants after Stage I Palliation of Single Ventricle Physiology: Is it Feasible?
Background: Automated home monitoring devices capable of transmitting data (vital signs, answers to questions, and lab values) over standard phone lines improves outcomes in adults with heart failure. Home monitoring also improves interstage outcomes of infants with single ventricle physiology after stage 1 palliation, but published studies utilize daily nurse/family communication, which may not be practical in many centers. We present a novel automated home monitoring solution that could allow for more widespread implementation of home monitoring in this population.
Methods: Home monitoring devices capable of measuring and storing weight, oxygen saturation and heart rate and allowing for manual entry of oral intake and answers to 5 questions were deployed in infants’ homes at the time of discharge after stage 1 palliation for hypoplastic left heart. Parents were instructed to obtain and transmit data daily via standard telephone connection. Data was stored on a central server and accessed and reviewed on a daily basis by a nurse practitioner or physician. Values (absolute and relative) were established that would prompt direct telephone contact, clinic visit, and automatic admission. Families were surveyed (1 - 5 scale with 5 being most positive) regarding satisfaction, ease of use, and perceived increase in safety.
Results: Five patients underwent home monitoring, for a total of 195 monitored patient-days. Successful transfer of data was as follows: weight - 167 days (86%), pulse oximetry and heart rate - 195 days (100%), and caloric intake and questions - 193 days (99%). Average weight gain was 34 grams/day. Interventions resulting from monitoring included adjustment of feeding regimen (1 patient), unscheduled clinic visit (1 patient) and unscheduled hospital admission (2 patients, 1 for lower saturation and 1 for decreased oral intake). Mean survey scores for satisfaction, ease of use, and increased safety were 4.2, 3.8, and 4.2.
Conclusion: Automated telemedicine-based home monitoring of high-risk neonates following single ventricle surgery is feasible, can capture a significant amount of clinical data, and has the potential to allow for early intervention. Early findings suggest families are satisfied with telemedicine home monitoring.
- © 2010 by American Heart Association, Inc.