Remote Cardiac Monitoring: Overview

In healthcare software development since 2005, ScienceSoft leverages its IoMT expertise to design and develop remote cardiac monitoring solutions for real-time visibility into patients’ heart conditions.

Remote Cardiac Monitoring In Brief

Remote cardiac monitoring (RCM) solutions proved to be highly efficient when used for cardiac disease monitoring and prevention, outpatient, postoperative, prenatal and athletic monitoring. The solutions leverage technologies like IoT, artificial intelligence, machine learning to continuously monitor patients' cardiac parameters. According to the research, RCM helps reduce atrial arrhythmia hospitalizations by 65% and reduce cardiac patients’ hospital stay length by 9-17%.

Remote Cardiac Monitoring Market

The remote cardiac monitoring market was estimated at $4.98 billion in 2021 and expected to amount to $31.67 billion by 2028 at a CAGR of 30.3%. The demand for remote heart monitoring solutions grows due to the spread of cardiovascular diseases worldwide and the risks of on-site visits caused by the COVID-19 pandemic.

How Remote Heart Monitoring Works

Architecture

A remote cardiac monitoring solution usually consists of the following elements:

Smart cardiac devices

– connected medical devices (e.g., an implantable cardiac monitor, a cardioverter-defibrillator, an artificial pacemaker, a wearable sensor, a loop recorder) that collect cardiac data (e.g., heart rate) and send it to the cloud server for storing and analysis.

Patient mobile application

– for patients to view their cardiac health parameters (e.g., heart rate, cardiac events) and the state of a connected cardiac device, log their symptoms, etc.

Cloud server

– for storing, processing and analyzing device-generated data (e.g., heart rate, tachycardia cases), analyzing patient information from EHR (e.g., new prescriptions), etc.

Doctor application

– providing a cardiologist, a primary care physician, a physiotherapist, other healthcare specialists, with data on connected cardiac device state, patients’ cardiac health reports and alerting medical staff on detected cardiac abnormalities.

Admin web panel

– to manage multiple user role settings (e.g., enable or restrict cardiac monitoring data review and cardiac monitoring reports editing), update cardiac care specialists’ schedules, confirm online appointment requests, etc.

A sample architecture of a RCM solution - ScienceSoft

Use cases

Cardiac rhythm management device monitoring

The solution enables a patient, a cardiac device technician, and a doctor to check data from a patient’s implantable rhythm management device (performance, battery life, etc.) and get notifications on the risks of device malfunction or patient’s health abnormalities.

Cardiac disease prevention

The solution provides a doctor with a patient’s data from an RCM device (e.g., ECG patch) and reports about identified abnormalities (e.g., arrhythmias, palpitations, bradycardia). The doctor can spot the developing pathologies (e.g., atrial fibrillation, atrial flutter), schedule more detailed patient screening, prescribe therapy and medications, etc.

Outpatient and postoperative monitoring

After a patient is discharged from a hospital or diagnosed with a chronic cardiac disease (e.g., heart failure), a cardiac care team can monitor an outpatient’s real-time cardiac data (e.g., via heart rate monitor, blood pressure monitor, pulse oximeter) and receive notification if the risk of cardiac complications is identified.

Prenatal cardiac monitoring

For higher-risk pregnancies (patients with diabetes, cardiovascular diseases, etc.), the solution enables non-invasive maternal and fetal heart rate monitoring to identify complications early, which results in improved prenatal care quality and maternal and fetal outcomes.

Sports medicine

While training, athletes can use dedicated RCM solutions to get a health state assessment from a sports doctor and consultations on their cardiac health and training program to maximize the benefit of their physical training and reduce heart risks.

Essential RCM functionality

Detection of cardiac symptoms

The solution processes cardiac devices’ signals to accurately detect a heartbeat, classify beats, eliminate side noises. Using ML, an advanced RCM solution identifies changes in heart rhythm from normal parameters (e.g., detects arrhythmia, ventricular tachycardia, atrial fibrillation) and notifies patients and doctors.

Cardiac data analytics and automated RCM reports generation

The RCM solution automatically logs, processes and analyzes cardiac data using AI to identify trends and predict cardiac events. The insights (e.g., predicted cardiac events) are visualized on doctor-facing dashboards and reports. Based on this data, doctors can adjust the treatment, training program, or schedule examinations.

Configuration of threshold monitoring parameters

Based on a patient’s health records, a doctor can configure monitoring parameters for the detection of symptoms specific to a patient’s disease. If the measurements exceed pre-set thresholds, the system automatically sends an alert (e.g., an app dashboard alert, email, SMS) to a patient, a cardiologist, a cardiac nurse, etc.

Device failure identification

Thanks to IoT-based device tracking, the RCM solution (e.g., pacemaker remote monitoring system) detects actual and potential hardware failures and device programming errors and alerts a patient, a cardiac technician, or a doctor about them.

Symptoms log for patients

A patient logs cardiac and cardiac-related symptoms (e.g., palpitations, shortness of breath, stress, fatigue) and their lifestyle habits (diet, physical activity, etc.) to provide a cardiac care team with the overall patient’s health state view.

Online patient-doctor communication

Doctors can schedule e-visits to check patients’ health state, provide them with care instructions and feedback on medical tests’ results in real-time, etc. Patients can also initiate communication with a cardiologist using an in-app chat to discuss new symptoms and get advice on their alleviation, or schedule a telemedicine appointment with a doctor.

Remote Cardiac Monitoring Solution: Project Example by ScienceSoft

Customer

A US company providing healthcare, sport, military organizations with research on the population’s health and effective training techniques.

Solution

ScienceSoft delivered an iOS app that can perform evaluation of the initial fitness level, training progress monitoring, identification of the changes in fitness, etc.

Project details

The evaluation relies on the Heart Rate Variability (HRV), lying-to-standing test plus Valsalva maneuver with deep breathing.
The app supports Wahoo Fitness, 60beat BLUE Heart Rate, Zephyr wearable heart monitoring devices.
Based on the analyzed health data, a physician, trainer or medical officer can measure the patient’s response to exercise stress.

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Technology Elements for RCM Solutions

Clouds

Cloud databases, warehouses and storage

AWS

Azure

Google Cloud Platform

Analytics of cardiac data

AWS

Azure

Others

Real-time data processing

Admin web panel development

Back end

Front end

Mobile applications development (for patients and doctors)

Specific RCM Challenges and Solutions

Challenge #1

Accuracy of cardiac measurements can be compromised due to improper usage of remote cardiac monitoring devices by patients.

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Solution:

To help patients improve the quality of measurements, add instructions on app-device pairing, device location and operation, etc., to a patient app. For example, for ECG sensors, the app can regularly send notifications reminding a patient to check the sensor’s location, integrity, etc.

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Challenge #2

The system can misinterpret predictable changes in cardiac data (e.g., change in the heart rhythm due to drug intake) as potential cardiac risks and send false alarms to the patient app and the doctor app.

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Solution:

ScienceSoft recommends integrating the RCM solution with EHR to get the information about a patient’s prescriptions that may change the cardiac measurements and add a medication intake log for patients. After that, the normal parameters in the RCM analytics algorithms can be adapted to the changes in the treatment resulting in a minimized number of false positive alarms.

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Cost Drivers and Investments

ScienceSoft defines the cost of development of a remote patient monitoring system for cardiac patients by analyzing the following factors:

General investment size factors

The complexity of cardiac monitoring solution features (including those in a patient app, a doctor app, and an admin web panel).
A number of cardiac device types connected to the software.
Connectivity technologies of cardiac devices (e.g., Wi-Fi, Bluetooth).
The number of user roles.

Operational costs

Cloud services usage (e.g., cloud data storage and analytics, cardiac devices connectivity).


	The cost of a remote cardiac monitoring application ranges from $200,000 to $250,000+, according to ScienceSoft’s experience in healthcare IT.

Remote Cardiac Monitoring Solution Consulting and Development

With 18 years of experience in healthcare IT and 12 years of experience in IoT, ScienceSoft’s team helps design and build advanced remote cardiac monitoring systems.

Remote cardiac monitoring solution consulting

Market and competitors’ analysis (for product companies).
Remote cardiac monitoring app concept productization (for product companies).
Business and technical requirements elicitation.
RCM features listing.
High-level design of scalable software architecture.
Technology stack selection.
TCO estimation of the remote cardiac monitoring system.
ROI calculation.

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Remote cardiac monitoring solution development

Market analysis and RCM solution requirements elicitation (for product companies).
Scalable software architecture planning.
Selection of cardiac monitoring devices (if required).
Sleek UX and UI design.
Development and quality assurance of the remote cardiac monitoring solution.
HIPAA, GDPR, MDR, and FDA compliance.
Application support and evolution (if required).

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About ScienceSoft

ScienceSoft is a global IT company with 34 years of experience in IT consulting and software development headquartered in Texas, US. Being ISO 13485-certified, we design and develop tailored IoMT solutions for efficient remote patient monitoring according to the requirements of the FDA and the Council of the European Union. We are ready to deliver RCM solutions aimed at improving chronic cardiac disease management and heart conditions treatment.