Important Technology
The technology identified for post-discharge management of congestive heart failure (CHF) and diabetes mellitus (DM) is telehomecare monitoring based on the Internet of Medical Things (IoMT). Upon discharge, a patient can put on sensing devices – glucose and electrocardiogram – to allow a nurse to check his/her vital signs remotely (ReferralMD, 2018). Thus, this technology provides a practical approach to collaborative long-term disease management in-home or community settings.
What It Is
IoMT describes wireless or wired infrastructure comprising medical sensors and applications that share data with hospital IT platforms (ReferralMD, 2018). Automated remote monitoring tools (RMTs) capture and transmit patient data to facility workstations via the Internet. Nurses can then review and interpret this information to track parameters like blood sugar level (DM) and electrocardiogram data (CHF). Since IoMT supports data security and interoperability, it is consistent with meaningful use requirements (stage II) meant to improve post-discharge safety and quality outcomes (McBride, Delaney, & Tietze, 2012).
How It Promotes Safety
IoMT is an essential technology for enhancing patient safety in chronic disease management after discharge. First, sensors worn by a patient obtain objective data that supplement subjective patient reports to support an accurate assessment of disease progression and medication efficacy (ReferralMD, 2018). Nurses can access this information from hospital computer systems to assist in transition care (Johnson & Webber, 2014). Second, IoMT supports home remote monitoring of therapy compliance and timely interventions. Electronic data capture, transmission, and review by nurses are critical in the preventive management of chronic diseases after discharge.
Other ways in which IoMT promotes safety include automation of device and therapy records (reduces medical errors) and precision medicine that is optimized for each patient to minimize adverse effects (ReferralMD, 2018). Further, an inbuilt feedback system allows for disease management adjustments for optimal treatment results. Thus, IoMT enhances safety through informed clinical decisions and improved patient monitoring for better compliance with therapy, self-monitoring, etc.
Why It Would Help
IoMT includes devices that capture and transmit data on core physiologic parameters via the Internet. Since the client is a frequent flyer, sensors that are accessible from a wireless environment can help monitor his two conditions – CHF and DM. Further, nurses could engage him in self-monitoring of blood glucose (BG) to achieve better glycemic control. The remote surveillance of BG will indicate patient compliance with the recommended dietary regimen, exercises, insulin dosage, etc. It will also inform treatment decisions and changes to avoid symptom exacerbations (hypoglycemia or hyperglycemia) that could require readmission. For CHF, an implanted cardiac defibrillator can be used to monitor drug efficacy and weight and symptom changes in real-life settings, i.e., home or in-flight. Rapid clinical assessment and response based on data transmitted by this device can help avert sentinel events, improve the quality of life, and reduce 30-day readmissions.
Reason for the Selection
The client has two chronic conditions that require long-term management. IoMT, a technology that uses sensors, can help achieve optimal clinical outcomes for this patient. It supports the remote assessment of compliance levels and medication efficacy and outreach case management based on patient-generated BG and electrocardiogram data by a nurse. One improvement that could enhance the capability of IoMT is including a messaging system to allow clinicians to prescribe virtual self-management plans based on patient-generated information received. The data would support care coordination, promote patient engagement, and minimize emergency department visits through outreach case management.
References
Johnson, B., & Webber, P. (2014). An introduction to theory and reasoning in nursing (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
McBride, S., Delaney, J., Tietze, M. (2012). Health information technology and nursing. The American Journal of Nursing, 112(8), 36-42. Web.
ReferralMD. (2018). Top 13 healthcare technology innovations of 2018. Web.