title: Innovative telemonitoring system for cardiology: from science to routine operation.
abstract: OBJECTIVE
  Results of the Austrian MOBITEL (MOBIle phone based TELemonitoring for heart failure patients) trial indicate that home-based telemonitoring improves outcome of chronic heart failure (CHF) patients and reduces both frequency and duration of hospitalizations. Based on lessons learned, we assessed the weak points to clear the way for routine operations.
  
  
  METHODS
  We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements. The following components have been identified: a patient terminal with highest usability, integrated way to document drug-intake and well-being, and automated event detection for worsening of CHF. As a consequence the system was extended by Near Field Communication (NFC) technology and by an event management tool.
  
  
  RESULTS
  Usability evaluation with 30 adults (14f, median 51y. IQR[45-65]) showed that 21 (8f) were able to immediately operate the system after reading a step-by-step manual. Eight (6f) needed one time demonstration and one man (80y) failed to operate the blood pressure meter. Routine operation of the revised system started in March 2009. Within 9 months, 15 patients (4f, median 74y. IQR[71-83], all NYHA-III) transmitted 17,149 items. 43 events were detected because of body weight gain of more then 2kg within 2 days. 49 therapy adjustments were documented. Three patients stopped using the system, two (1f) because of non-compliance and one (m, 82y) because of death. Overall, the rate of adherence to daily data transfer was 78%.
  
  
  CONCLUSIONS
  First results confirm the applicability of the revised telemonitoring system in routine operation.
authors.affiliation: Safety & Security Department, AIT Austrian Institute of Technology GmbH , Graz, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Kastner
authors.forename: J
authors.initials: J
authors.lastname: Morak
authors.forename: R
authors.initials: R
authors.lastname: Modre
authors.forename: A
authors.initials: A
authors.lastname: Kollmann
authors.forename: C
authors.initials: C
authors.lastname: Ebner
authors.forename: Fm
authors.initials: F
authors.lastname: Fruhwald
authors.forename: G
authors.initials: G
authors.lastname: Schreier
keywords: Heart failure; eHealth; mobile phone; near field communication technology; telemedicine