Tue, Dec 12, 2017

MobiGuide pilots start!

The first patient was enrolled into the MobiGuide atrial fibrillation (AF) pilot in early April in Pavia, Italy

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Celebrating with cake! The first atrial fibrillation pilot patient enjoys chocolate cake with his cardiologist Dr Carlo Napolitano and cardiac nurse Roxana Ioana Budasu.

Currently 14 patients are participating, seven with gestational diabetes (GDM) and seven with AF. The patients are wearing the MobiGuide Body Area Network or BAN (a smartphone and a set of body-worn sensors). The BAN monitors relevant biosignals and gives them feedback, advice and reminders based on clinical guidelines. Biosignal data collected by the BAN and other patient data are analysed and processed by a distributed clinical decision support system which uses a formalized version of the relevant guideline as a knowledge base.

Atrial Fibrillation pilot
By mid June 6 patients, two female and four male, all previously diagnosed with Paroxysmal AF, had been enrolled to the AF pilot in Italy. The AF pilot is conducted at Fondazione Salvatore Maugeri Clinica del Lavoro e della Riabilitazione (FSM) in Pavia. Two of the AF patients are working and one travels abroad frequently, so makes use of the semi routine context. Since then a seventh AF patient has been recruited into the pilot.

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Enrolling the first atrial fibrillation patient into the MobiGuide pilot

Positive results were achieved within weeks of starting the pilot. In one patient with suspected AF who suffered very occasional palpitations, continuous monitoring by means of the MobiGuide system enabled a new diagnosis of supraventricular tachycardia to be established. So the system has demonstrated clinical value in the first weeks of the pilot.

The AF Patients have already given some feedback on the use of the system; their opinion was positive overall. For example, patients appreciated receiving reminders on the smartphone whether or not the phone is connected to the internet. Some teething problems were reported and short battery life was identified as an issue. Patients also made some suggestions for added features and one patient asked when they could have the system on their own smartphone.

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Atrial Fibrillation patient uses the MobiGuide system at home

GDM pilot
At Corporacio Sanitaria Parc Tauli de Sabadell (CSPT) in Spain a total of seven patients have been recruited into the GDM pilot since it started in early May. Each patient received around one hour’s training in the use of the system. As part of the enrollment process each patient entered their personal preferences and contexts together with the endocrinologist so that the guideline-based guidance can be adapted to their personal situation and preferences. Measurement and management of blood glucose levels, ketones and blood pressure is important for GDM patients, who are also are advised to follow dietary and exercise therapy. To help with this the GDM app on the MobiGuide BAN connects to a glucometer and a blood pressure monitor. Patients enter their ketonuria readings and record thier physical exercise sessions and any deviations from their dietary régimen manually.

The pilots allow the technical system to be tested and improved by the engineers. The pilots are also designed to provide valuable data for the evaluation. Feedback from patient and clinician users are key sources of information for the evaluation team led by Professor Silvana Quaglini at the University of Pavia.