Akademik Veri Yönetim Sistemi
Gökalp Clarke H., Aydın Avci I., Şahin M. K., Kulakaç Ö., Gedikli Ö., Çavuşoğlu F., et al.
Türkiye Sağlık Enstitüleri Başkanlığı (TÜSEB) Araştırma Projesi, 2025 - 2027
We will develop and evaluate a system for the management of patients with chronic disease using remote patient monitoring technology to demonstrate ability to manage at scale and have flexibility to manage specialist conditions. We investigate management of hypertension at large scale as the most prevalent chronic disease in Turkey, report conditions associated with hypertension such as atrial fibrillation (AF) and transient ischaemic attack (TIA), and manage pregnancy with risk of pre-eclampsia as specialist condition. Patients are monitored in their own home and take and send regular (daily) measurements that are used to detect deterioration and initiate prompt intervention by medical services. Beyond the technology, we develop new pathways of care that use locally based services for early care and management, with shared data and strong communication links between primary and hospital care. Management in primary care avoids hospitalisation, but well defined pathways of care support early managed admission to hospital that can result in earlier discharge and reduce total hospitalisation, avoid emergency evacuation, provide improved patient outcomes, and reduce cost.
The project will develop all the technology for a complete remote patient monitoring system that includes; Bluetooth enabled blood pressure monitor to automatically send all observations, Bluetooth enabled proteinuria measurement device (optical reading of urine strip), gateway based on cell technology to forward data to server, portal for clinicians to view data and manage all clinical aspects of the patient. Many telehealth systems suffer from and excessive number of false positive and false negative alerts that reduced confidence of the system in the users, and cause unnecessary investigation and miss patients in need of care. We will develop algorithms and AI techniques to improve accuracy to determine patients in need of intervention and reduce the number of false alerts.
We will develop our system based on technology developed in the Reaction and inCasa projects that used international standards for health data (IEEE 11073 and HL7). This project extends the work of our other TUSEB project to manage patients with congestive heart failure (CHF) to demonstrate ability of RPM to manage patients with different diseases. Initially we will integrate the monitoring devices using the proprietary Bluetooth protocol of the manufacturer, however will investigate developing and implementing the General Health System (GHS) profile of Bluetooth, a plug and play protocol that simplifies adding new types of device to the platform, avoiding the need to develop new software for every device from every manufacturer. The approach to use standards based messaging will be extended to investigate integration with national systems such as eNabiz.
We evaluate our system through a randomised controlled trial of 9 months with 100 hypertensive patients with the technology and 100 control patients; and 20 patients with risk of developing preeclampsia or with preeclampsia and 20 control patients. The project has 4 main objectives:
1. Develop the technology for remote patient monitoring for production and commercialisation in Turkey.
2. Develop algorithms and techniques to improve accuracy of detection of patients in need of intervention and reduce the number of false alerts.
3. Design and develop the clinical services to manage patients with chronic disease using remote patient monitoring in the community for the Turkish health care system.
4. Evaluate the system to determine the benefit to health care in terms of cost and efficiency, and the benefit to the patient in clinical outcomes through a randomised controlled clinical trial.