The role of telemonitoring in patients on home mechanical ventilation

Abstract

There is a growing number of patients being treated with long-term home mechanical ventilation (HMV). This poses a challenge for the healthcare system because in-hospital resources are decreasing. The application of digital health to assist HMV care might help. In this narrative review we discuss the evidence for using telemonitoring to assist in initiation and follow-up of patients on long-term HMV. We also give an overview of available technology and discuss which parameters can be measured and how often this should be done. To get a telemonitoring solution implemented in clinical practice is often complex; we discuss which factors contribute to that. We discuss patients' opinions regarding the use of telemonitoring in HMV. Finally, future perspectives for this rapidly growing and evolving field will be discussed.

FIGURE 1

Structure in development for telemonitoring of home mechanical ventilation in the Netherlands. Various monitoring data from patients being treated by the four home mechanical ventilation centres in the Netherlands can be synchronised and collected on one platform and then sent to the different electronic patient systems and collected for research purposes. IHE PCD: Integrating the Healthcare Enterprise Patient Care Device; FHIR: Fast Healthcare Interoperability Resources (a standard describing data formats and elements and an application programming interface for exchanging electronic health records (EHRs), created by the Health Level Seven International healthcare standards organisation); XDS: cross-enterprise document sharing (facilitates the exchange of documents through registration, distribution and access across health enterprises of patient EHRs); DAP: data and analytics platform; XCA: Cross-Community Access (supports the means to query and retrieve patient-relevant medical data held by other communities).