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Home Healthcare, Hospice, and Information Technology Innovations Conference

Innovations in Home Healthcare, Hospice, and Information Technology

A forum towards achieving evidence-based diffusion and implementation of innovations

Fri, Nov 3, 2017
Friday, Nov 3, 2017, Washington - D.C.
H3IT: Home Healthcare, Hospice, and Information Technology Conference Washington D.C., 2014
The Electronic Collection and Presentation of
Nocturnal Heart Failure
Cubby L. Gardner
, Harry B. Burke
eart failure is a major public health problem in the United States (U.S.), with high personal and institutional
Reducing heart failure readmissions is a national priority.
Most heart failure data is often have
diculty appropriately recognizing and responding to their worsening heart failure.
Heart failure patients
experience a high burden of night time symptoms that reduce quality of life and increase their risk of hospi-
Unfortunately, there is little systematic literature addressing nocturnal heart failure, despite new ndings that
a number of physiological functions exhibit circadian rhythmicity, including cardiovascular function
and extracel-
lular uid shifts.
redol_s_no cturnal_2010
The current approach to the description of heart failure relies on data collected
in hospitals and clinics. The problem is that most heart failure patients experience acute exacerbations outside of hospitals
and clinics, often at night, at home, when signs and symptoms of disease are not systematically collected. This investigation
explores the application of FDA approved technology
to acquire information related to the detection of progressive heart
failure decomp ensation at home.
Methods: This study assesses the feasibility of using physiologic data acquisition devices and a tablet-based application to
collect disease-related data in home-dwelling heart failure patients. After data have been collected, clinicians assess the us-
ability of an electronic display of nocturnal heart failure information derived from the database of physiologic and subjective
data. This study asks the following research questions: 1) What is the feasibility of collecting ecologically valid physiological
data (heart rate, respiratory rate, blood oxygen saturation, blood pressure, and weight) and subjective data(self-assessment
features such as relative shortness of breath, swelling, pain, moo d, appetite) by home-dwelling heart failure patients? 2) Can
an electronic display of physiological and psychological data be constructed that meaningfully conveys nocturnal heart failure
information? 3) What is the patients’ and clinicians’ assessment of the usability of a system for electronically collecting and
presenting nocturnal heart failure information? The setting for this study is Walter Reed National Military Medical Center.
Results: The results of the investigation are pending completion of data collection. We will determine the feasibility of
collecting and displaying physiologic and subjective data collected from home-dwelling heart failure patients. Descriptive and
summary statistics will be used to characterize the sample and describe feasibility. Patients will evaluate the us ability of the
data collection devices using the System Usability Scale, which is a 10-item instrument assessing dimensions of usability.
Each dimension of usability is assessed on a 5-point Likert scale. Responses are calculated to pro duce a score from 0 to
100, with 68 representing an average score. Intra-class correlations will be calculated across devices and patients. With the
collected data, we will create an electronic display of nocturnal heart failure information. Clinicians will assess usability of
the information display with the System Usability Scale.
The investigators hypothesize that the mean score will be greater
than 68. This hypothesis will be evaluated with the two-tailed Student’s t-test. The study is powered (n=37) to detect a
10-point dierence at 0.80 power, alpha = 0.05.
Discussion: There is little or no research on the physiological and subjective states of home-dwelling heart failure patients
over night. In this study we investigate the feasibility and usability of a system to collect physiologic and subjective informa-
tion from heart failure patients, in their homes, at night. Then we assess clinicians’ perceptions of usability of a system to
display information constructed from the collected data. We anticipate that this electronic display will demonstrate above
average usability.
Conclusion: This study is a rst step toward developing an understanding of nocturnal heart failure in home-dwelling
patients and methods to capture reliable physiologic and subjective data. We believe that this system will, in the future
provide valuable information for clinicians to improve their management of heart failure patients.
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