How technology is revolutionizing care for patients with chronic conditions

The idea for the technology began in 2014 when, encouraged by the Portuguese government’s drive to develop technical solutions that would allow doctors to treat patients remotely, Hope Care’s José Paulo Carvalho met Dr. Luís Oliveira from Cova da Beira Hospital, which serves the municipalities of Covilhã, Fundão, Belmonte, and Penamacor. 

As Dr. Luís explains, “We began working with Hope Care on an innovative new system that would allow us to monitor the health of patients with chronic heart failure remotely, reducing the need for them to come to hospital.”

Treating an aging population 

In Portugal, like most developed countries, chronic heart failure is the most frequent cause of hospital admissions in people over the age of 65, adding considerable strain to hospitals and their resources each year.  

“It’s increased by more than a third in the last decade,” explains Dr. Luís. “Like many countries, our population is aging and we are treating this disease on almost a daily basis.” 

The patient prognosis is poor. There’s a 12.5 percent risk of death during a hospitalization, with a high chance of acute events occurring undetected after patients are sent home. Risk of death is 17 percent in the first year. 

“We see a quarter of patients readmitted within the first month of leaving the hospital and half within the first year,” Dr. Luis continues. “It’s bad for the patient’s quality of life and adds a huge financial cost to our healthcare system.” 

Something needed to be done to help reduce these rising hospital admissions without risking any acute events going undetected. That’s where Hope Care’s HCAlert patient monitoring system—powered by Microsoft Azure, and tailored to meet the needs of his patients—has proved to be a lifesaver. 

Saving lives at home  

Patients use simple Bluetooth-connected devices to share daily measurements—such as their temperature, weight and blood pressure. The data is then submitted via smartphone to Hope Care’s centralized system and stored securely in the cloud.   

“Asking patients to collect their own data was the challenge,” says Carvalho. “We wanted to be sure that the app’s interface made it easy for older patients to track themselves, without always relying on support from family or hospital staff.” 

Once the data is submitted, the hospital is informed if it shows a patient’s condition has transgressed set parameters, allowing doctors to act accordingly. Medical staff are also better able to detect early signs of decompensation—and take action to prevent a patient experiencing an acute event, by adjusting their medication or providing advice.

“It’s a simple and relatively inexpensive system,” adds Dr. Luís. “The doctors train the patients and their carers how to use the device and it’s very straightforward so that patients are easily able to use it after just one session,” he says.

“It helps the patient to feel very active in their own care—we see greater adherence to prescribed medication treatments and to a healthy lifestyle. It also provides a constant link and source of communication between the patient and the department, which in turn helps them feel safe and more comfortable.”

Storing and managing sensitive data of this kind also requires specific certifications to ensure that hospitals are compliant, which could now easily be accessed at any time through the cloud-based Azure Trust Center.

“Using Azure makes it easy for us to comply with local data regulation,” explains Carvalho. “Patient data is kept secure and ensures we are compliant with medical standards. And the cloud gives us the power and flexibility to process huge amounts of data on demand.”

Adapting to a pandemic

Though originally designed to help with chronic heart conditions, HCAlert also delivered unforeseen benefits when social distancing measures were put in place in March 2020. 

By allowing doctors to monitor older patients with chronic conditions remotely—and eliminating or reducing the need for hospital visits—HCAlert has made the isolation of vulnerable people possible, without compromising their healthcare.  

“Although we don’t have many cases of COVID-19 in the municipalities that our hospital serves, isolation of vulnerable chronic patients is crucial,” explains Dr. Luís. 

Additionally, Carvalho realized that HCAlert could also be applied to care for isolated chronic patients who had contracted COVID-19.   

“I could never have imagined that the monitoring system I had developed for patients with chronic heart disease would one day play a role in the war against a global pandemic.”  

“With COVID-19 patients, you need to measure the same vital signs as you would with chronic heart disease. We’ve just altered the algorithm to deploy different parameters for COVID-19 patients.”  

Expanding the solution  

In a time when many healthcare providers share the challenges of strained budgets and fewer clinicians, HCAlert has helped provide the ongoing care these patients need.  

“We’ve seen an 85 percent reduction in visits to emergency departments and cut hospital admissions in half,” says Carvalho. “By monitoring these chronic conditions remotely, we’re able to help these patients live healthier and happier lives outside of the hospital.” 

This has brought major benefits for hospitals too, offering a cost-effective way to provide high-quality care services and use their resources effectively, all without putting anybody in unnecessary jeopardy. 

“By reducing the need for hospital visits, the annual cost reduction per patient is over €47,000,” explains Dr. Luís. “And mortality in patients that have trialled the system has decreased to 9.5 percent—45 percent lower than the 17 percent expected by European Guidelines.”

Given the massive migration of the medical profession to online virtual consultations, Hope Care also integrated Microsoft Teams with the monitoring system, allowing clinicians and nurses to collaborate and when needed, and contact patients through a secure video call to provide further support and guidance.

“It’s one of the biggest benefits of Teams,” adds Dr. Luís. “If a patient’s data goes outside the interval range, we can easily give them a call and make small adjustments to the medication they are already taking. They feel like they are responsible for their own health and we can stay focused on other patients in the hospital who need our help.”

For Hope Care’s monitoring technology, this is only the beginning. With government support, HCAlert is able to do even more in the field of cardiology, helping to improve the health of patients with chronic conditions across the country.

“We already have several public hospitals using our system across Portugal,” say Carvalho. “Not just for chronic heart failure but also other conditions such as diabetes, hypertension, and asthma. It’s a great success not just for the hospitals but also the patient’s quality of life.”