Shirali Girish, Erickson Lori, Apperson Jonathan, Goggin Kathy, Williams David, Reid Kimberly, Bradley-Ewing Andrea, Tucker Dawn, Bingler Michael, Spertus John, Rabbitt Leslie, Stroup Richard
From the Ward Family Heart Center, Children's Mercy Kansas City, MO (G.S., L.E., J.A., D.T., M.B., L.R., R.S.); Health Services and Outcomes Research, Children's Mercy Kansas City, MO (K.G., D.W., K.R., A.B.-E.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.S.).
Circ Cardiovasc Qual Outcomes. 2016 May;9(3):303-11. doi: 10.1161/CIRCOUTCOMES.115.002452. Epub 2016 May 10.
Infants with single ventricle require staged cardiac surgery, with stage I typically performed shortly after birth, stage II at 4 to 6 months of age, and stage III at 3 to 5 years of age. There is a high risk of interstage mortality and morbidity after infants are discharged from the hospital between stages I and II. Traditional home monitoring requires caregivers to record measurements of weight and oxygen saturation into a binder and requires families to assume a surveillance role. We have developed a tablet PC-based solution that provides secure and nearly instantaneous transfer of patient information to a cloud-based server, with the capacity for instant alerts to be sent to the caregiver team. The cloud-based IT infrastructure lends itself well to being able to be scaled to multiple sites while maintaining strict control over the privacy of each site. All transmitted data are transferred to the electronic medical record daily. The system conforms to recently released Food and Drug Administration regulation that pertains to mobile health technologies and devices. Since this platform was developed in March 2014, 30 patients have been monitored. There have been no interstage deaths. The experience of care providers has been unanimously positive. The addition of video has added to the use of the monitoring program. Of 30 families, 23 expressed a preference for the tablet PC over the notebook, 3 had no preference, and 4 preferred the notebook to the tablet PC.
单心室婴儿需要进行分期心脏手术，I期手术通常在出生后不久进行，II期手术在4至6个月大时进行，III期手术在3至5岁时进行。在I期和II期之间婴儿出院后，存在较高的阶段间死亡率和发病率风险。传统的家庭监测要求护理人员将体重和血氧饱和度测量值记录在活页夹中，并要求家庭承担监测职责。我们开发了一种基于平板电脑的解决方案，该方案可将患者信息安全且几乎即时地传输到基于云的服务器，并能够向护理团队发送即时警报。基于云的信息技术基础设施很适合扩展到多个站点，同时能对每个站点的隐私进行严格控制。所有传输的数据每天都会传输到电子病历中。该系统符合美国食品药品监督管理局最近发布的与移动健康技术和设备相关的规定。自2014年3月开发此平台以来，已对30名患者进行了监测。没有发生阶段间死亡。护理人员的反馈一直是积极的。增加视频功能后，监测程序的使用有所增加。在30个家庭中，23个家庭表示更喜欢平板电脑而不是笔记本电脑，3个家庭没有偏好，4个家庭更喜欢笔记本电脑而不是平板电脑。
