Introduction:
The COVID-19 epidemic generated severe issues for the medical field. It has become quite challenging to provide patients with necessary cardiological care while protecting them from potential sources of infection. Cardiology was one field of medicine where the first electric and electronic technology was employed for diagnosis and therapy. Body signs that are easy to monitor and understand, such as arterial blood pressure and heart rate, can provide helpful and vital information about a patient's condition.
To transmit this type of information, the concepts of telemonitoring and remote therapy have emerged. Some of the most important applications of telemonitoring in cardiology include implanted devices like pacemakers and defibrillators, wearable sensors, and data processing units. For healthcare systems, telemonitoring provides significant financial and practical advantages. So there is a tremendous demand for these technologies to be developed further.
What Are Implantable Electronic Devices for the Heart?
The permanent implantable electronic devices that have been utilized in cardiology are as follows:
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Implantable cardiac defibrillators (ICDs).
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Cardiac resynchronization therapy devices.
Remote Monitoring (RM) - The simplest method of remote monitoring is to collect data from an implanted device using a transmitter (provided for the patient) and communication technology that allows remote data transfer.
Smartphone - Data on blood pressure, heart rate, and body weight can be collected by an external device and uploaded to a compatible smartphone, which can also identify technical issues such as, low battery levels, electrode malfunction, and insulation flaws. Nowadays, the device can also be used to monitor changes such as, heart rate (including the beginning of arrhythmias), breathing rate, and level of activity.
Wearable Technology - Using an external wearable gadget is now affordable and effective because of recent advancements in chip electronics and sensor technology. They may offer details that result in hospitalization or medical intervention. Moreover, they enable the remote care, raising rural populations' access to higher-quality healthcare. The device itself, a network, a communications interface that enables data transfer, and an analytics platform that integrates massive volumes of data and finds critical information. Holter monitors were the first wearables to be used for cardiac remote monitoring. Although wearable device sensors can come in a variety of designs, they typically record blood pressure, electrocardiograms (ECGs), and occasionally oxygen saturation as well.
Ballistocardiogram - The ballistocardiogram measures the repetitive movement of the body caused by blood ejected with each heartbeat and is the most frequently employed technique for registering heart rate and ECG signals.
Phonocardiography and Seismocardiography - They both have the potential to produce informative signals. A system for registering ECGs using just one chest lead is also available. It is possibly more effective than conventional Holter monitoring at detecting arrhythmias.
Photoplethysmography - Photoplethysmography uses infrared light that is absorbed differently by different tissues, and the detector can gauge how much blood is passing through the arteries.
How to Prepare for a Telemedicine Visit?
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Inform the patients about the telemedicine process.
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Check the patient's ability to access telemedicine and broadband.
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A questionnaire and a list of symptoms are uploaded by the patient.
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Physiological data such as blood pressure, heart rate, and glucose activity may be automatically submitted.
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The information is incorporated into electronic medical records.
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The doctor looks over the survey results and data.
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A telemedicine visit is a virtual meeting between patients and doctors.
What Are the Safety Concerns of Telemedicine in Cardiology?
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One of the main obstacles to the more widespread usage of these apps is data security. ICD remote access security is a concern that cannot be disregarded should be expanded to clarify what ICD stands for (implantable cardioverter-defibrillator).
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Concerns about remote monitoring's security are one of the safety concerns with telemedicine. As per a study, only 30 percent of the 600 most popular health applications have a privacy policy.
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Data sales to third-party domains are also found in the most popular health and fitness apps. Unfortunately, some of the transferred data may also be used by insurance firms to distinguish between various customers' insurance rates.
What Are the Drawbacks of Telemedicine in Cardiology?
Awareness of the Patient - Understanding the patient-clinician interaction is a key element. Building awareness that telemedicine is a practical and economical choice is a part of that cultural transformation. It is crucial to explain to patients exactly how and when this service can meet their medical needs.
Cultural Differences - Many people find it difficult to imagine developing a relationship through live video and email conversations. Since establishing relationships with patients has always been a key component of medicine, the adoption of telemedicine necessitates patient education and conversation to manage expectations. Clinics might, for example, produce a film describing the telemedicine procedure and what a physician can and cannot manage through remote data gathering and video visits. The clinical team should play a part in making sure that patients understand the limitations of telemedicine.
Privacy - Both patients and professionals have serious concerns about this. Minimum security standards should be established by law for telemedicine and in-person visits.
Communication Barriers - Communication hurdles due to lack of proficiency in language or accent could be solved by delivering translation services during video visits on live video platforms. Additionally, payment should include on-demand translation services.
Payment - Copay assistance programs for telemedicine patients may encourage virtual follow-up visits. Some patients are eligible for transportation reimbursements to go to their in-person appointments, and these reimbursements might also be used to cover the copayment for online follow-up sessions.
Conclusion:
The integration of remote monitoring into routine cardiological care is unique, contemporary, and very promising. The challenges still exist despite significant technological advancements. There is emerging proof of the advantages of remote monitoring in numerous clinical settings in the trials that have been done so far. The use of remote monitoring can lead to fewer hospital or clinic visits, just when necessary, and the early detection of adverse events. The development of ECG monitoring textiles and wearable cardioverter-defibrillators are examples of the advancements made in the realm of wearable technology. Therefore, remote monitoring has the potential to lead to cost savings, improved outcomes, and a better quality of life.
