Advances in Telemonitoring of Home Mechanical Ventilation (Brazil): Outcomes and update

Introduction:Telemonitoring of Home Mechanical Ventilation(TM-HMV) is associated with enhance of patient compliance, better clinical outcomes, and cost reduction.

Aim:To apply telemonitoring(TM) in Home Mechanical Ventilation(HMV) as a management tool, quality care, economic and clinical resources in a private home care program with national deployment.

Methods:Analysis at 225 patients at HMV between September/2021 to February/2023. After hospital discharge, the patient received a clinical standard care protocol of visits: multidisciplinary team.

Patients were screened and remotely monitored by a coordinator using AirView® could-based monitoring system.
HMV was provided by Astral?, Stellar? devices, coupled with a modem for telemonitoring capability, and AirCurve?(ResMed Inc.).
All patients were provided with clinical standard care according to Home Care protocols. Based upon TM-HMV analysis, Clinical coordinator reached out to the clinical staff for case discussion, corrective actions and follow up.

Results:Currently, 171 patients are active, 18 died, 14 without telemonitoring, and 22 were discharged. Total of 448 actions identified: 49% ventilatory adjustment optimizing comfort and synchrony, 33% ventilatory fine tuning, 6% anticipating imminent complications, 6% successful total weaning after active management and 6% downgrade.

Management actively contributed with weaning, discharge of equipment due to lack of adherence and technology downgrades, contributing to savings US$120 K for the paying source.

Conclusion:TM of HMV program by a Home Care provider, was associated with clinical improvement and cost reduction.