Minding Broken Hearts

UHN cardiologist Dr. Heather Ross says cardiac patients using technology to monitor their own conditions are less likely to be readmitted to hospital. PHOTO By THOMAS BOLLMANN

Mobile technologies allow high-risk cardiac patients to look after themselves at home

Patients at high risk of cardiac arrest can now be closely monitored at home through a smartphone app that transmits vital signs to their health-care team. An increase in weight, for example, may prompt an intervention call from the doctor’s office, says Dr. Heather Ross, a cardiologist at the Peter Munk Cardiac Centre at University Health Network, which is implementing the mobile technology.

“We find out the patient had dim sum or pizza – something that is notoriously high in salt content. His weight goes up as a result,” notes Dr. Ross. “It becomes a teachable moment for the patient.”

For Dr. Ross and her team, “teachable moments” help patients transform their health behaviour, and mobile technology makes that possible.

A cardiac patient recovering at home could monitor his condition, via Bluetooth, with a special smartphone app that takes readings from a sensor-equipped blood-pressure cuff and weight scale and then asks him pertinent questions.

According to Health Canada, close to half a million Canadians are currently suffering from heart failure.

With a survival rate of 2.1 years on average after diagnosis, the toll on hospital resources is critical. “There’s an epidemic in this country,” says Dr. Ross, who is director of the Ted Rogers Centre for Excellence in Heart Function. “Our priority is to reduce readmission rates by 50 per cent and reduce length of stay by 20 per cent.”

In addition to implementing smartphone apps to aid its patients at home, UHN is also developing wearables and medical peripherals that will communicate with patients’ phones and back to the hospital, says biomedical engineer Joseph Cafazzo, senior director of UHN’s Healthcare Human Factors team.

Biomedical engineer Joseph Cafazzo demonstrates how UHN
cardiac patients will use a cardiac patch and smartphone to
monitor and adjust their heart rates at home.

Clinical trials involving 100 patients and technologies have shown improved outcomes. “We’ve been monitoring these patients, who are the sickest of the sick,” says Mr. Cafazzo. “A patient empowered to do self-care will have better outcomes than anything the health-care system can do.”

UHN is leading the way for other organizations that are starting to explore innovative uses of mobile technologies. Canadian businesses overall, however, have been slow to give up their traditional phone systems, according to “Transformation of Work,” a recent study conducted by Ryerson University with support from Rogers Communications. They have yet to maximize the full range of benefits provided by mobile solutions, such as wireless and mobile devices, Web-based collaboration tools, machine-to-machine solutions and cloud-based IT services.

“We have digital Canadians but obsolete offices,” notes Nitin Kawale, president of the enterprise business unit at Rogers.

While the benefits of these technologies are well documented – boosting productivity by as much as 25 per cent – many companies are slow to invest because of cost and security.

The study noted that fewer than 30 per cent of organizations understand the value of mobile technology. “The question is, do you have the tools in place that allow your people, customers and partners to communicate with each other and have impromptu collaborations?” says Mr. Kawale. “When you enable the smart people in your organization with this technology, they will do absolutely amazing things.”

For example, among the wearable technologies being examined at UHN is a monitor that sits in the patient’s pulmonary artery to measure lung pressure, as well as a cardiac patch that, when applied to the chest, will provide feedback on heartbeat variations.

If the heart condition becomes a concern, the patient can start using a paced breathing method, developed by UHN, to modulate it and bring the heart rate back to normal.

A start date this fall is planned for implementing the sensor-equipped cardio technology, and Dr. Ross says UHN is looking light-years ahead to find ways to combine various technologies into a comprehensive solution set.

It would be much like a Star Trek episode, she says, where somebody is scanned by a tricorder, the science fiction series’ hand-held device used to record and analyze data.

“You’ll be able to track [a patient’s] weight, blood pressure and heart rate, actual ECG and even fitness levels,” she says. “Then you can see when they are running into trouble and intervene.” —Peter Giffen

This is a branded content story written for Rogers Communications, running in the Globe and Mail newspaper and on its site. It is part of a larger package of stories, running in different issues of the newspaper and online. I helped develop the story lineups for the three packages, assigned writers, wrote key stories, arranged for photo shoots and worked with a videographer to create web videos.