Scenarios

  • Scenario 1: Detect Orthostatic Hypotension before it Occurs

  • Scenario 2: Quantifying Orthopnea (or shortness or breath) in a sleeping position in Heart Failure Patients

  • Scenario 3: Detect Symptoms in Women that Could Lead to a Heart AttacK

  • Scenario 4: Intermittent Claudication (Cramping) due to Peripheral Vascular Disease

  • Scenario 5: Determine the Root Cause of Exhaustion during Effort

  • Scenario 6: Monitor Eating Habits for Patients at Risk of Heart Failure

  • Scenario 7: Help Patients after a Heart Attack or Heart Surgery Return to a Healthier Lifestyle

  • Scenario 8: Many people suffer from stress. Chronic stress is a predictor of heart disease. How can we help people cope with the stress?

  • Scenario 9: Help Heart Attack Patients by Detecting Depression in the Early Stages

  • Scenario 10: Improve the Management of CHF Medication

  • Scenario 11: Monitor and Manage Heart Failure in Pets

  • Scenario 12: Remote Monitoring of ICDs (Implantable Cardioverter Defiblirators

Scenario 1

Orthostatic Hypotension (or postural hypotension)

Problem 📃

  • Patients feel dizzy when they change their position from sitting to standing up.

Background 🏔

  • Blood pressure drops when changing position.
  • This is one frequent cause of syncope or fall, especially in patients taking multiple cardiovascular medications
  • How passively detect episodes of orthostatic hypotension before collapse happens while the patient is in real-world environment?
  • This could help physicians for differential diagnosis of syncope and adjusting the medications and dosages if necessary.

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Frequency of recurrence of symptoms
  • Wearable Sensors

Stakeholders 👥

  • Patient
  • Physician

Action Items 🛠

  • Measure how frequent the patient has been changing position from sitting to standing up without having any issue (tracking possible deterioration of this situation
  • Monitor blood pressure without being overly intrusive. Heart beat rates and rhythm can also be indicative of some cardiovascular disorders

Links 🔗

Scenario 2

Quantifying Orthopnea (or shortness or breath) in a sleeping position in Heart Failure Patients

Problem 📃

  • Heart failure patients can't sleep flat and usually increase their number of pillows as their dyspnea aggravates, or sleep sitting in a chair. Can we detect their condition worsening by monitoring their sleep conditions?

Background 🏔

  • Orthopnea is the sensation of breathlessness in the recumbent position.

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Frequency of recurrence of symptoms
  • Wearable Sensors

Stakeholders 👥

  • Patient
  • Physician

Action Items 🛠

  • An application can be created to measure the angle at which the patient is sleeping comfortably and collect data as the angle changes to alert the physician, as a sign to the situation becoming worst.
  • We need something like level bubble to find out the inclination. We can use inclinometers and or clinometer. Use an app that works as clinometer for tracking. We can probably miniaturize the technology to go with activity trackers like Fitbit. This alone cannot be a primary symptom, so we need other sensors to make an educated conclusion on the condition of a patient.
  • Create an app that uses the phone microphone to assess the breathing. The frequency can be collected and an alarm can be triggered to wake up the patient if he is having longer periods of apnea.

Links 🔗

Scenario 3

Detect Symptoms in Women that Could Lead to a Heart Attack

Problem 📃

  • Uncomfortable pressure, squeezing, fullness or pain in the center of your chest (Angina). It lasts more than a few minutes, or goes away and comes back. Recognizing it and getting treated early may prevent a heart attack.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
  • Nausea/vomiting and back or jaw pain.
  • Low levels of the hormone Estrogen. Estrogen has a positive effect on the inner layer of artery wall, helping to keep blood vessels flexible. Low levels of this natural hormone can contribute to heart attack.

Background 🏔

  • Atypical symptoms on women during heart attack or myocardial infarction can delay diagnosis, treatments initiation and seeking help.
  • Cardiovascular disease is the No. 1 killer of women in the United States, affecting one out of every three in the United States.
  • Nearly half of African-American women have cardiovascular disease.

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Frequency of recurrence of symptoms
  • Wearable Sensors

Stakeholders 👥

  • Patient (Female)
  • Physician

Action Items 🛠

  • Monitor intervals of chest pressure or any of the symptoms mentioned
  • Measure the level of estrogen.

Links 🔗 None

Scenario 4

Intermittent Claudication (Cramping) due to Peripheral Vascular Disease

Problem 📃

  • Finding ways to objectively quantify the distance at which the pain occurs (for example number of steps before pain starts and forces the patient to stop). This could help the physician to monitor more precisely the disease progression in their patients.

Background 🏔

  • Intermittent claudication is the pain in the legs that typically occurs with walking and goes away with rest.
  • This is usually related to the narrowing of arteries that supply the legs with blood.

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Frequency of recurrence of symptoms
  • Wearable Sensors

Stakeholders 👥

  • Patient
  • Physician

Action Items 🛠

  • An application can be used to count steps and mark pain events

Links 🔗 *

Scenario 5

Determine the Root Cause of Exhaustion during Effort

Problem 📃

  • Some patients express the feeling of "I had to stop, I couldn't go further" Was this related to shortness of breath or peripheral limitation (legs)?

Background 🏔

  • Shortness of breath on patients with cardiovascular disease is associated with increase in heart rate.
  • Its important to help physicians detect if this is related to shortness of breath or peripheral limitation (legs)

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Frequency of recurrence of symptoms
  • Wearable Sensors

Stakeholders 👥

  • Patient
  • Physician

Action Items 🛠

  • Monitoring the heart rate upon start of any activity can help determine if the heart rate increased faster before an intermittent claudication episode.
  • Cameras in phones can help detect skin colors that may provide information such as oxygen levels

Links 🔗 None

Scenario 6

Monitor Eating Habits for Patients at Risk of Heart Failure

Problem 📃

  • Many people tend to get unhealthy food during social occasions, setting up the conditions for a possible heart failure

Background 🏔

  • Warn heart failure patients about social occasions in which the risk of indulgence in unhealthy food is high enough to induce an acute episode of worsening in the next days

Data/Sensors/Devices Required 📄📱

  • Medical records
  • Food labels
  • Nutrition facts
  • Social activities

Stakeholders 👥

  • Patient
  • Food Suppliers
  • Restaurants

Action Items 🛠

  • Keep track of type of food taken during social occasions, informing the patient with estimated intake totals of different ingredients that may cause risk to the heart
  • Display nutrition facts for all types of food offered to the public
  • Create mobile app for scanning any food labels and display facts about calories, fat, etc, in a more clear an understandable way for people.

Links 🔗 None

Scenario 7

Help Patients after a Heart Attack or Heart Surgery Return to a Healthier Lifestyle

Problem 📃

  • The daily routine of patients that have had a heart attack or heart surgery, has many changes that are not easy to be followed by many patients. Medicine intake, physical activity, controls, eating habits are some of the things that these type of patients need to adjust to. How can we help them meet those challenges?

Background 🏔

  • Returning to normal function and adopting a healthier lifestyle are challenges faced by people who have had a heart attack or heart surgery.

Data/Sensors/Devices Required 📄📱

  • Blood Pressure Monitors
  • Heart rate Monitors
  • Medicine Intake
  • Daily Diet
  • Wearable Sensors

Stakeholders 👥

  • Patients
  • Relatives

Action Items 🛠

  • Patients must take measures of their heart rate and blood pressure several times a day and make a chart to identify high spots and reasons that could have caused that.
  • Alarms need to be set to take medicine at the exact times
  • Understand the limits of physical activity and engage with continuous supervision based on possibilities

Links 🔗

Scenario 8

Many people suffer from stress. Chronic stress is a predictor of heart disease. How can we help people cope with the stress?

Problem 📃

  • Chronic stress from stress inducing events (e.g. stuck in traffic or stock market collapsing) is a predictor of Heart Disease. How can we monitor stress in daily life? How can we help people cope with their stress?

Background 🏔

  • Chronic stress is a predictor of heart disease and acute stress can cause heart events and even death. Measuring stress is often subjective or limited to the lab setting.

Data/Sensors/Devices Required 📄📱

  • Blood Pressure monitors
  • Heart rate monitors
  • Medicine intake
  • Daily Diet
  • Location monitors (phone or car)
  • Traffic reports

Stakeholders 👥

  • Patient
  • Surrounding Atmosphere/People

Action Items 🛠

  • Exercise frequently
  • Collect duration times of high activity, heart rates and blood pressure
  • Keep a record and create a chart it to notice improvements or possible risk
  • Using location sensor (either phone or car monitor) determine you are stuck in traffic - and play calmer music on the car
  • Call your broker

Links 🔗

Scenario 9

Help Heart Attack Patients by Detecting Depression in the Early Stages

Problem 📃

  • It is common for patients to be depressed after a heart attack worsening the situation. Could we detect depression earlier? Could we find ways to help people with depression seek and find help?

Background 🏔

  • This can be detected by looking at mood changes, the desire to be alone, or the lack of communication. Now this does not indicate depression but could be a start to determine if the patient is depressed.

Data/Sensors/Devices Required 📄📱

  • Physical Activity
  • Social Life
  • Wearable Sensors

Stakeholders 👥

  • Patients
  • Relative
  • Friends

Action Items 🛠

  • Energy levels provided by apps

Links 🔗 None

Scenario 10

Improve the Management of CHF Medication

Problem 📃

  • Management of CHF is currently treated by diuretic* control, by adjustment of medication. The care-taker/family reports "observable" changes to the CHF patient at home. Medical doses can change biweekly/weekly/dailybasis, and there can be a fine balance between being under-medicated for the proper diuretic and over medicated (hyponatremia) which could lead to strokes/death. How can we better present these dose frequencies and/or manage these diuretics so it's easier on the patients?

Background 🏔

  • CHF is a chronic condition where body fluids are not cycled through the bloodstream due to failure of the heart muscles, where the heart muscles are unable to pump blood effectively resulting in fluid build-up or back-up in other parts of body such as lungs and legs. This buildup can be debilitating, and additionally, makes the already damaged heart work even harder. CHF is the leading cause of hospitalizations for people 65 years of age and older

Data/Sensors/Devices Required 📄📱

  • Diuretics
  • Medical Records
  • Wearable Sensors

Stakeholders 👥

  • Patient
  • Relatives
  • Care-taker
  • Physician

Action Items 🛠

  • Diuretics stimulate the kidneys to remove more water and salt (sodium) from the body. This can help relieve swelling that happens because of heart failure
  • IOT sensors may include body weight scales, pressure monitors on lower limbs or arms for fluid build-up, sensors on the lungs for fluid build-up, respiratory rate monitor for shortness of breath, a picture of skin turgor (reaction to pinch), rest heart rate monitor, multi-lead electrocardiograms, and blood pressure.
  • Diuretic control with using three components: fluid index, breath index, and personalization parameters.
  • In the last few years a CardioMEMs pressure measurement system has been FDA approved. The small device is implanted in the heart. Used with wireless monitor system it can provide daily pulmonary artery pressure measurements for CHF monitoring.

Links 🔗

Scenario 11

Monitor and Manage Heart Failure in Pets

Problem 📃

  • In dogs/pets, heart (cardiac) failure is usually not curable. However many pets can continue to enjoy a good quality of life with proper management. The management would be the continuous adjustment of medication over time reactive to sensors to prevent or delay cardiac emergencies. Can we aid the management of cardiac failure in dogs with IOT sensors?

Background 🏔

  • Decreased exercise tolerance and activity level may be one of the first signs of heart failure. A trend change in the rest heart could indicate issues. The heart recovery rate after strenuous activities may also indicate issues. Can we long term monitor the heart rate of dogs both during rest and strenuous/active periods?

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Activity Levels
  • Wearable Sensors

Stakeholders 👥

  • Pet
  • Care-taker

Action Items 🛠

  • Can we monitor a pet's normal breathing (respiratory) rate during periods of rest/sleep over time?
  • Track changes to appetite, water intake, attitude, and general activity, which could be frequently monitored

Links 🔗 None

Scenario 12

Remote Monitoring of ICDs (Implantable Cardioverter Defiblirators

Problem 📃

  • Patients typically have to come to the clinic every three to six months so doctors can make sure their ICD is working correctly. There are two major drawbacks to the in-clinic follow-up:
    • They are time-consuming for both the patient and the clinic
    • There's no link between the time of the appointment and [a heart problem] or device malfunction

Background 🏔

  • About 180,000 ICDs are implanted in the U.S. each year*. The battery-powered devices are designed to continuously monitor heart rhythms and shock the heart back into its normal rhythm when certain abnormal heart rhythms occur or the heart stops beating altogether.

Data/Sensors/Devices Required 📄📱

  • Medical Records
  • Activity Levels
  • Wearable Sensors

Stakeholders 👥

  • Patient
  • ICD or Pacemakers
  • Physician

Action Items 🛠

  • Can an efficient IOT algorithm be employed to efficiently monitor and detect abnormalities in the ICD transmitted signals?
  • Can a system be put in place to get proper timely notification of ICD issue to the doctor's office, patient, and care provider.

Links 🔗

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