By: Ankur Gupta, MS2
An acute exacerbation of heart failure is not much different from drowning, except in this case the fluid filling up the lungs is due to back pressure from a failing left ventricle. In many cases, these episodes are preventable – and with 670,000 sufferers of congestive heart failure and an annual cost of $29 billion, prevention is critical. And as any internist or cardiologist knows, successful prevention hinges on effective outpatient monitoring and management, which is far easier said than done.
In May, the UCLA School of Nursing along with the UCLA Wireless Health Institute published a study on a system to remotely monitor for symptoms indicative of CHF related decompensation. Dubbed WANDA, the system uses wireless devices to track weight, blood pressure, activity levels, and the Heart Failure Somatic Awareness Scale (HFSAS). The goal and idea are simple enough – catch early signs of an exacerbation, intervene, and keep patients at home.
WANDA is a customizable mobile platform that integrates seamlessly into patients lives and uses automated data analysis to allow for easy physician review. So when the system catches a slow increased in weight, blood pressures above goal, or dropping activity levels – all warning signs for decompensated heart failure – physicians can intervene before the patient ends up in the hospital.
While the tangible improvement seen in the WANDA study is somewhat marginal (a 5.6% reduction in readings outside the acceptable range), the foundation of the system represents an important step towards remote monitoring of chronically ill patients. Daily monitoring of symptoms for CHF patients has long been thought to be successful in catching acute situations earlier, yet many patients do not have the time or motivation to take the readings and send them to a physician.
Management of chronic medical conditions is becoming increasingly important, particularly in preventing the acute exacerbations and long-term complications that cost billions each year. Systems like WANDA will become more and more important in motivating and enabling chronically ill patients to monitor and manage symptoms before they need acute hospitalization. While WANDA may not be battle ready just yet, look for it and similar mHealth platforms to emerge in the near future.
Source: Journal of Medical Systems (subscription required) [link]