Post-Discharge Remote Monitoring Using Smartwatches In Stroke: A Pilot Study |
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Dr. Jake Hayward, Principal Investigator Our research team is studying the feasibility of using wearable sensors for clinical monitoring in patients who are rehabilitating at home in remote and rural areas. The team represents a partnership between University of Alberta researchers and the Early Supported Discharge (ESD) unit at Camrose Hospital. During COVID-19, we recognized the importance of remote monitoring systems that would allow patients to recover at home rather than in hospital, especially for remote and rural populations who tend to be under-supported after an acute hospital admission. With seed funding from Covenant Health, we have built a research program exploring the use of smartwatches as tools for multi-modal remote patient monitoring. Modern smartwatches are affordable, intuitive to operate and increasingly accurate in measuring physiologic parameters in free-living environments, including activity, sleep, and vital signs (ex. heart rate and oxygen saturation). We therefore believe that these devices will improve rehabilitation outcomes by tracking activity outside of the clinic and improving patient safety by detecting and preventing adverse events such as falls and infections. Our feasibility trial in post-COVID patients is now complete, having enrolled a total of 10 patients at the height of the pandemic. The remote monitoring protocol consisted of wearing a FitBit smartwatch continuously and completing daily symptom surveys and bi-weekly mental health surveys using a smartphone application (text or email, per patient preference). We used exit surveys and interviews to assess technology usability and patient experience. Results show that compliance with the protocol was high and patient experience was positive, overall. Devices were worn for 83% of study-hours, 74% during weeks 1-4 and 88% thereafter. Physical and mental health surveys were completed 83% and 72% of the time, respectively. Patients perceived moderate-high device usability/acceptability (3.9/7), clinical utility (3.5/7) and positive impacts on mental health (3.8/7). Interviews revealed an overall positive patient perception of wearable devices and RPM with variable degrees of concern around data privacy/security. A preliminary analysis of longitudinal associations between smartwatch parameters and mental/physical symptoms is ongoing. As COVID impacts have lessened, the ESD team is no longer supporting post-COVID patients, and we are now adapting our protocols for post-stroke patients. We are currently enrolling post-stroke patients in a similar feasibility trial using FitBit devices for tracking of rehabilitation outcomes and prediction/prevention of adverse events, including an exploration of machine learning techniques for outcome prediction.
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