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    The combined effects of an aging population and the increasing incidence of chronic diseases are leading to more hospital admissions. This situation is increasing the pressure on already overburdened care facilities. The challenge for hospital systems is to avoid service overcrowding – especially in the current pandemic context -, without sacrificing the care of their patients. How to relieve the hospitals while ensuring patient follow-up? Here are some answers.

    INCREASE IN THE NUMBER OF CHRONIC PATHOLOGIES

    Leading cause of death in the world according to the WHO, chronic diseases are responsible for 63% of deaths. Heart failure, diabetes, COPD, cancer… the management of these pathologies must be carefully reviewed, with the aim to better the patient’s quality of life, through an adapted continuum of care.

    Nowadays, the therapeutic follow-up of most patients with chronic diseases aims to maintain a stable condition, through drug and surgical treatments, but also through prevention advice to encourage a healthier lifestyle. Care is provided during periodic consultations throughout the year and during hospitalizations, which are often too numerous. For several chronic pathologies such as heart failure, respiratory failure or even cancer, these hospitalizations are often associated with increased morbidity and mortality.

    AGEING POPULATION

    In the next 40 years, the number of people above the age of 65 in the European Union is expected to double, increasing from 85 million in 2008 to 151 million in 2060. Considering the fact that this population consumes more care and that it often experiences chronic diseases, its care constitutes a challenge for hospitals. The issue at stake is to implement more precise and personalized long-term monitoring systems to manage patients at home, and only admit to hospital those who really need it.

    AVOID (RE)HOSPITALIZATIONS WHENEVER POSSIBLE

    Readmissions are taking a toll on national health budgets, which are already under pressure due to increasing demands and rising healthcare costs, a situation that is expected to worsen in the upcoming years. The development of ambulatory surgery and the shortening of the average length of stay are part of the measures implemented, but they will require increasingly precise home monitoring.

    Ultimately, hospitals should be able to limit readmissions and maintain sick people at home by guaranteeing them a high-quality follow-up, to avoid a saturation of the care system. In France, a study conducted on 1,000 patients aged 75 and over admitted in nine hospitals in an emergency, showed that 14.2% of patients had to be readmitted within 30 days, unexpectedly. Implementation of procedures ensuring patient mobility and independence in the 24 hours following surgery, clear communication with patients, close monitoring of their health status in the two weeks following their discharge from the hospital… Several factors have been identified to anticipate health deterioration and avoid re-hospitalization.

    CHRONIC PATHOLOGIES: HOW TO ENSURE REMOTE PATIENT MONITORING?

    Monitoring patients by implementing new home health devices can help avoid unnecessary (re)hospitalizations. Remote patient monitoring is an effective response to this issue as it allows healthcare professionals to monitor patients remotely, by having access to physiological data in quasi-real time. Reducing office visits, anticipating worsening of the patient’s health status, making early diagnosis, improving the patient’s quality of life by ensuring a real continuity of care… all are advantages guaranteed by the implementation of a remote monitoring system.

    To be truly useful to healthcare professionals, without constituting an additional workload, it is preferable that remote monitoring be based on a multiparametric device, supported by a comprehensive service providing complete care. This kind of solution allows the remote surveillance of patient’s physiological variations, without impacting their quality of life. Electrocardiogram, respiration, temperature, pulmonary impedance… recent technological breakthroughs make it possible to equip medical devices with multiple sensors, providing healthcare professionals with relevant data for diagnosis. In the long term, chronic conditions could benefit from a more personalized, regular, and accessible monitoring.

    Aware of the necessity to relieve hospitals while guaranteeing an efficient monitoring of patients, Chronolife has developed a connected smart t-shirt, able to continuously collect 6 physiological parameters, throughout the patient’s daily life. Machine washable and easily “forgotten” by patients, this medical device is easy to wear and constitutes a reliable tool to implement remote monitoring.

    Eventually, the adoption of such solutions by care systems should lead to a better management of patients with chronic diseases and secure homecare for sick and frail people, ensuring a continuum of care between hospital and home.

    One example of the collateral consequences of the Covid-19 pandemic is that patients suffering from chronic pathologies have been avoiding hospital consultations since March 2020. Out of fear of being contaminated, but also on the recommendations of the health authorities, they preferred to postpone or simply cancel their appointments, causing health professionals to fear a delay in treatment and a potentially serious risk of decompensation. Under such context, the widespread use of teleconsultation and telemonitoring has never been more relevant. Explanations.

    CHRONIC DISEASES VS COVID-19: A WORRYING SITUATION

    At risk for serious medical complications, some chronically ill patients were encouraged to be more cautious with Covid and to stay at home as much as possible. For these patients, periods of confinement presented a real risk: many cancelled their routine follow-up appointments. A false good idea, which health professionals tried to warn about as early as the end of March.

    Moreover, the increase in sedentary lifestyle can have consequences on the exacerbation of several pathologies such as depression, obesity, etc.

    Everything from implementing separate circuits between suspect patients and non Covid-19 patients, disinfecting       premises and equipment, personalizing support methods, to providing automatically renewed prescriptions, several actions have been undertaken to reassure the chronically ill and make them return to hospitals, albeit without always meeting with success. At the same time, doctors have proposed teleconsultation. “For a patient with heart failure, for example, we can simply ask them to weigh themselves at home and ask them if they experience shortness of breath when they climb the stairs. This is one of the signs that will lead us to suggest that they come and see us, while putting protective measures in place,” explained Pierre-Louis Druais, a general practitioner and member of the scientific council, on BFMTV in April.

    Teleconsultation has therefore established itself as a safe way to keep in touch with patients, but simple bathroom scales   quickly reach their limits when it comes to providing a positive patient experience and serving as viable diagnostic tools. With devices such as connected scales offering limited visibility into patients’ health status, remote monitoring devices allowing continuous multi-parameter monitoring has thus proven to be particularly suitable.

    THE ADVANTAGES OF REMOTE MONITORING

    Preventable hospitalization, easier home care, improved medical follow-up, and early detection of a deterioration in health status for appropriate medical decision making… These are just some of the prime examples of the great promise of remote monitoring for patients with diabetes, COPD, sleep apnea and heart failure. In this new paradigm, patients can continue to live normally at home, knowing that their health status is being monitored. But for telemonitoring to really work, it is necessary to rely on medical devices that are reliable, comfortable and ergonomic for the patient, who must be able to live a normal life, forgetting that they are telemonitored. A new range of lighter, more reliable medical devices is emerging with new embedded technologies, all with the objective of better monitoring and greater acceptability by patients.

    Last but not least, these tools must be offered to healthcare professionals to help them better monitor their patients without burdening them with additional work, i.e. generating untimely alerts or false alarms…

    CHRONOLIFE: 6 MEDICAL DEVICES IN 1 FOR CONTINUOUS REMOTE MONITORING

    Aware of these issues, Chronolife has developed a patented intelligent t-shirt, capable of continuously capturing 6 different physiological parameters in real life :

    •  Electrocardiogram
    • Chest breathing
    • Abdominal breathing
    • Physical activity
    • Temperature
    • Pulmonary Impedance

    Unlike other telemonitoring solutions, Chronolife integrates the sensors directly into the fabric, so patients can wear the shirt like any other garment and machine wash it. This ease of use improves compliance and paves the way for continuous remote monitoring. Thanks to Chronolife, healthcare professionals have accurate information on the health status of their patients, without the need to have them travel to the hospital. This reliable diagnostic tool enables them to fully ensure the continuity of care between the hospital and the patient’s home, and avoid any risk of contamination to these fragile populations.

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