Project Objective
The CAP project objective is to develop clinical solutions for managing and preventing cardiovascular diseases to reduce burden on health care systems and improve the quality of service. This will be achieved by integrating R&D in clinical aspects of cardiovascular diseases, human factors, information systems, and monitoring technology.
The expected outcome of the CAP project is to establish a sustainable home–based care process assisted with information technology tools by developing a platform which provides both hardware and software solutions for cardiovascular disease management and prevention.
The project will conduct a large scale clinical trial to study the clinical and economic outcomes associated with the processes and technologies.
Care Model for Sustainable Management of Chronic Disease
An integrated primary and ambulatory care model is being recognised as the future in health care to manage chronic diseases to relieve the burden on health services. The Queensland Strategy for Chronic Disease 2005–2015 focuses on implementing such care models in primary healthcare settings in place–based initiatives. The primary aim of this model is to prevent and manage chronic disease at home environment and avoid hospitalisation.
Demonstrated Experience
The Australian e–Health Research Centre has the expertise of liaising with clinicians and running ambulatory monitoring clinical trials. The CAP project is currently finalising a clinical trial in conjunction with the Redcliffe–Caboolture Health Service District across the local community primary healthcare setting.
The preliminary results indicate that by using ambulatory monitoring devices measuring physical activity and ECG on cardiac rehabilitation patients at home setting, it is possible to automatically extract clinically relevant information on patient’s behaviour and physical status. These measures include discriminating walking from other high intensity activities, calculating walking speed to determine index of functional capacity, energy expenditure and the amount and duration of walking events. Other developed measures that indicate patient’s functional capacity include fractal dimension to quantify gait patterns, detection and measurement of sit–to–stand transition speed and various measures on heart rate variability (HRV). All these measures indicate different aspects of patient’s physiological status during the rehabilitation and can be used to support the team of care professionals and patients for self management.
Current Work
Building on this expertise, the Australian e–Health Research Centre in collaboration with Queensland Health is planning to establish a home–based cardiac care model that utilises and integrates novel information technology software, algorithms, home care devices and systems. The project will test the home–based model by planning and conducting a large scale randomised controlled clinical study on four different home and hospital–based cardiac care models with and without the use of monitoring technology.
In addition to innovations in process development and evidence on clinical and economic outcomes, the trial is expected to create new clinical knowledge on physiological signal patterns, exercise, diet, lifestyle, and behaviour of cardiovascular patients in home care setting.
