TeleMED Partners with the University of Alberta for Hypertension in Seniors Trial
Dr. Raj Padwal, of the University of Alberta, and his research team have selected TeleMED Diagnostic Management Inc. (TeleMED) as its Health Technology Partner in a study titled Telemonitoring and Protocolized Case Management for Hypertension in Seniors. This study is funded by Canadian Institutes of Health Research, the major federal agency for funding health research in Canada, and will be a randomized controlled trial to determine if telemonitoring is the optimal method for controlling blood pressure in Canadian seniors.
According to study details, hypertension is highly prevalent in seniors with diabetes and substantially increases morbidity, mortality and health costs. However, treatment of hypertension in seniors with diabetes is a complex challenge. The need for aggressive BP control in seniors with diabetes must be balanced against the very real risk of serious treatment-related complications. Currently, office BP measurements are used to monitor the vast majority of Canadians with hypertension. However, office measurements require patients to attend office appointments and represents a barrier for seniors with mobility or financial limitations. Furthermore, measurements are usually taken infrequently (i.e., every few months) and this limits the ability to make timely therapeutic adjustments in the event that the BP is low or high. As a result, the Canadian Hypertension Education Program Recommendations Task Force (CHEP) recently released a strong endorsement of out-of-office over in-office measurements. Currently, though, the optimal implementation method for use in Canada, in terms of effectiveness, acceptability and costs, remains unclear.
Over 20 published trials reported clinically important BP reductions using home BP telemonitoring and case management. No trial in seniors has ever been performed and it is important to confirm feasibility, effectiveness, safety, usability and acceptability in this population specifically, or in Canada more generally. This study will be a 300 patient randomized trial in community-dwelling seniors that compares three in-home measurement models – measurement without telemonitoring, measurement with telemonitoring alone and measurement with telemonitoring plus case management.
TeleMED will custom-design, engineer, deploy and maintain a web portal for securely storing clinical data, controlling clinician access and displaying data. When designing the web portal, data interpretation and display are two key components that will be considered. Relevant data trends will be displayed for ease of interpretation, providing easier decision-making for the clinician. This will include any relevant data calculations such as daily, weekly and monthly BP averages and mean arterial pressure displayed on the graph with systolic and diastolic measurements. Data trends over time are vital; therefore, threshold based alert flags will be incorporated into the template to provide alarms when dangerous values and trends are transmitted by a patient. These thresholds will be set to correspond directly with the Canadian Hypertension Guidelines.
TeleMED’s role in this study leverages its extensive experience in providing comprehensive data management solutions to community laboratory networks, hospitals, research organizations and in home care settings across Canada. Its proprietary, sophisticated and intuitive ViTELflo data management system centralizes and distributes a wide range of medical diagnostic data, in an easy, rapid, secure and scalable manner, to stakeholders at multiple points. In addition, it supports large-scale storage and customizable data analytics. Assuming that this study demonstrates that BP telemonitoring and case management is valuable, safe and cost-effective, TeleMED has the resources and infrastructure to commercialize a fully-functional, user-friendly system, to scale up that system throughout Canada and to guarantee system sustainability.
TeleMED, an ISO 13485:2003 certified company, has been a pioneer in the development of powerful solutions for managing medical diagnostic test data. It serves an array of verticals in the healthcare industry including community laboratories, family physician groups, specialty clinics, occupational testing organizations and paramedical service providers.