Use Cases

This guide applies to any situation where Continua-compliant PHD data needs to be mapped to FHIR resources and/or such data needs to be read and interpreted by a consumer. In most cases PHDs are used in remote patient monitoring efforts but that does not mean within-enterprise uses of PHDs are excluded.

Remote patient monitoring is remote (home-based) monitoring of vital signs on a daily basis, to allow care providers to observe the health of their chronically-ill patients. Patients are enrolled to the remote health monitoring program on request (e.g. prescription) of their care provider, and obtain the necessary equipment and facilities in part or completely from the service provider. Patients preferably should be able to install and operate the necessary equipment themselves.

The scope of the remote patient monitoring includes:

• Automatic, device-reported vital signs, obtained from the PHDs

• Manual, patient-reported vital signs, obtained from the PHDs

• Patient takes episodic (typically up to a few times per day) scalar or short-vector vital signs measurements, notably weight, blood glucose level, blood-pressure plus pulse, ECG rhythm strip, etc

• Association of the measurements with the correct patient, proper timestamping, and potential correction for device-specific inaccuracies

• Batch delivery of measurements to the backend server ( E.g. health record server) for use by the care provider, and eventually without measurements getting lost or corrupted

• Installation and configuration of equipment (PHD, PHG) and facilities (power, phone, Internet), preferably by the patient

• Both single-user (personal) and multi-user (shared with residents) PHDs. (E.g. via multiple logical devices on a single physical device)

• Interoperability between PHD, PHG and backend server.

Example 1: Diabetes monitoring

A person is able to self-monitor and manage lifestyle aspects that affect the diabetes condition, and to enhance the value of the glucose readings from a portable glucose meter. This self-monitoring and management process is facilitated by one or more wearable monitors and interactions with one or more PHGs and back-end servers. The feedback the person receives is a function of continuous measurements collected by the monitor(s) they wear, periodic measurements about their physical state from a portable glucose meter or from the wearable monitor itself, and from manual entry of additional details. Also, the person may receive feedback about these measurements from a healthcare provider to support the treatment of that person’s diabetic condition. The purpose is both to ensure continued adherence to health monitoring and continual improvements in the relevant end-points such as quality of life, average measured glucose levels, etc.

Example 2: Healthcare with wearable sensor

One can manage his/her own health continuously by wearing sensors. A wearable sensor measures body activity, blood pressure, and/or SpO2. The wearable sensor sends the measured data to the user’s cell-phone (PHG). The PHG receives the measured and sends it further to the healthcare back-end server. This way the healthcare provider is able to follow the user's health condition and provide advices at the right moment of time. The PHG is also able to show the accumulated data stored in the healthcare server to the user, and/or display health advice from the healthcare provider to the user.

Example 3: Medical research

Another use case is participation in medical research. For example, a medical center associated with a large university is conducting a study on memory impairment interventions in the elderly. The data is collected online in association with a home healthcare service. The healthcare service views involvement in the study by their patients as therapeutic.