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动态监测有望为代表性不足的患者提供公平的个性化医疗服务。

Ambulatory monitoring promises equitable personalized healthcare delivery in underrepresented patients.

作者信息

Kulkarni Kanchan, Sevakula Rahul Kumar, Kassab Mohamad B, Nichols John, Roberts Jesse D, Isselbacher Eric M, Armoundas Antonis A

机构信息

Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA.

Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.

出版信息

Eur Heart J Digit Health. 2021 Jun 28;2(3):494-510. doi: 10.1093/ehjdh/ztab047. eCollection 2021 Sep.

Abstract

The pandemic has brought to everybody's attention the apparent need of remote monitoring, highlighting hitherto unseen challenges in healthcare. Today, mobile monitoring and real-time data collection, processing and decision-making, can drastically improve the cardiorespiratory-haemodynamic health diagnosis and care, not only in the rural communities, but urban ones with limited healthcare access as well. Disparities in socioeconomic status and geographic variances resulting in regional inequity in access to healthcare delivery, and significant differences in mortality rates between rural and urban communities have been a growing concern. Evolution of wireless devices and smartphones has initiated a new era in medicine. Mobile health technologies have a promising role in equitable delivery of personalized medicine and are becoming essential components in the delivery of healthcare to patients with limited access to in-hospital services. Yet, the utility of portable health monitoring devices has been suboptimal due to the lack of user-friendly and computationally efficient physiological data collection and analysis platforms. We present a comprehensive review of the current cardiac, pulmonary, and haemodynamic telemonitoring technologies. We also propose a novel low-cost smartphone-based system capable of providing complete cardiorespiratory assessment using a single platform for arrhythmia prediction along with detection of underlying ischaemia and sleep apnoea; we believe this system holds significant potential in aiding the diagnosis and treatment of cardiorespiratory diseases, particularly in underserved populations.

摘要

这场大流行让每个人都意识到远程监测的明显需求,凸显了医疗保健领域 hitherto 未见的挑战。如今,移动监测以及实时数据收集、处理和决策,不仅能极大地改善农村社区的心肺血液动力学健康诊断和护理,对于医疗服务获取有限的城市社区也是如此。社会经济地位的差异和地理差异导致医疗服务提供方面的区域不平等,以及农村和城市社区死亡率的显著差异,一直是人们日益关注的问题。无线设备和智能手机的发展开启了医学的新纪元。移动健康技术在公平提供个性化医疗方面具有广阔前景,正成为为难以获得院内服务的患者提供医疗保健服务的重要组成部分。然而,由于缺乏用户友好且计算高效的生理数据收集和分析平台,便携式健康监测设备的效用一直未达最佳状态。我们对当前的心脏、肺部和血液动力学远程监测技术进行了全面综述。我们还提出了一种基于低成本智能手机的新型系统,该系统能够使用单一平台进行心律失常预测以及潜在缺血和睡眠呼吸暂停检测,从而提供完整的心肺评估;我们相信该系统在辅助诊断和治疗心肺疾病方面具有巨大潜力,尤其是在服务不足的人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dde7/9707947/e7d1258413f3/ztab047f7.jpg

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