Pictured (L-R): Dr Phil Tideman, Paul Simpson and Claudine Clarke showcasing the home monitoring equipment and its ease of use.
A digital platform that uses artificial intelligence for chronic disease clinical decision support is bringing a new model of care to cardiac patients in rural areas.
For more than five years, South Australia's iCCnet (Integrated Cardiovascular Clinical Network SA) has deployed a telehealth home-monitoring program throughout remote and rural parts of the state, to ensure people living with cardiovascular conditions and other chronic illnesses receive high standards of care.
One of the program's key objectives is to keep patients away from primary healthcare services as much as possible, by allowing them to self-monitor at home with easy-to-use testing equipment. Participants are provided with a personalised kit, comprising a range of tools such as blood pressure monitors and pulse oximeters, so they can measure their vitals independently. Their results are then reviewed by their medical team, with any red flags triggering a phone call from staff.
Until recently, the system was overseen by a team of nurses and scientists who manually analysed patient data. But now, with support from MTPConnect's Growth Centre Project Fund in 2017, iCCnet has built upon its home-monitoring program with Hospital 4.0: a cloud-based artificial intelligence (AI) digital health platform that uses clinically derived algorithms to review patient results and submit alerts to staff when elevated risk factors are identified and patients require attention.
Hospital 4.0, which currently has around 100 patients enrolled, is halfway through a 12-month validation period, during which time patients are monitored by iCCnet staff in parallel to the system's algorithms, to confirm that the algorithms match manual clinical assessments. Eventually, the project will allow the same number of staff to monitor at least twice the number of patients - even more, over time, as the algorithms are developed and refined.
The program offers numerous benefits to patients and the broader healthcare system: widespread self-monitoring alleviates the burden on the sparse healthcare services in remote regions; chronic illnesses are actively monitored, preventing them from escalating; and patients are given peace-of-mind knowing that their health is being monitored by a medical team.
Another benefit came to light in 2020, with the onset of COVID-19 highlighting a problem in the delivery of healthcare, whereby sick and high-risk patients were forced to gather in waiting rooms to be seen by medical staff.
As Rosy Tirimacco, Operations and Research Manager at iCCnet, explained: "[2020 has shown that] telemedicine and home monitoring will play a crucial role in the future of primary healthcare. During the pandemic, the iCCnet home-monitoring platform which usually applied to cardiovascular disease was repurposed to help South Australians suffering from COVID-19, so that if we entered a second phase it could be used to regularly monitor a patient's health symptoms in hospitals, homes and quarantine hotels."
Tirimacco added that there are also plans to expand the program further, to support patients afflicted with other illnesses. "Over the past 18 months, the team has developed algorithms that will assist us in monitoring patients with hypertension, diabetes, heart failure or chronic obstructive pulmonary disease," she said.
"Patients across remote and rural South Australia are now being monitored by nurses and scientists to validate and tune the algorithms, ultimately allowing more patients to have their health monitored regularly from their own homes."
To date, Hospital 4.0 has garnered positive feedback from clinicians and patients alike. Clinicians report that patients seem to have developed a greater understanding of their condition; to be 'quite inspired' to take accountability for their own health and make lifestyle changes, when required.
One patient, who presents at a medical clinic twice weekly for dressing on a diabetic ulcer, is more in-tune with the day-to-day management of her condition since joining the monitoring program. Another patient had been experiencing hypoglycaemia due to a change in her medication, which was reported by her monitors. She has also made several life adjustments and is now better equipped to self-manage her illness.
Meanwhile, hospital staff find the convenience of being able to look at patient data prior to appointments means more time is spent in discussion with the patient during the consultation rather than reviewing results.
While Hospital 4.0 is currently only available in South Australia, the infrastructure is commercially scalable to extend to other parts of the country and beyond - a move that will enable healthcare providers to establish a central network to deliver the best care possible to patients, wherever they happen to be.
iCCnet includes over 70 hospitals, health centres and GP surgeries across South Australia. Its mission is to provide a state-wide provider clinical network which supports the practice of evidence-based medicine and continuous quality improvement in the management of cardiovascular disease across regional, rural and remote South Australia.
For more information, visit iCCNet.