30 Day Health
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30 Day Health provides a new mobile technology to improve patient management, schedule early intervention, improve medical treatment outcomes and, ultimately, reduce the staggeringly high number of hospital re-admissions
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This document summarizes a trial using remote patient monitoring technologies to provide care for patients with congestive heart failure and chronic obstructive pulmonary disease in their homes. The trial aims to validate cost savings, reduce hospital admissions and visits, improve patient self-management, and evaluate the technology solution. Early results show reduced hospitalizations and home visits. Patients reported increased support and management of their conditions, while nurses found increased access to patient data and flexibility in care.
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Basics of Electrocardiogram
CONTENTS
●Conduction System of the Heart
●What is ECG or EKG?
●ECG Leads
●Normal waves of ECG.
●Dimensions of ECG.
● Abnormalities of ECG
CONDUCTION SYSTEM OF THE HEART
ECG:
●ECG is a graphic record of the electrical activity of the heart.
●Electrical activity precedes the mechanical activity of the heart.
●Electrical activity has two phases:
Depolarization- contraction of muscle
Repolarization- relaxation of muscle
ECG Leads:
●6 Chest leads
●6 Limb leads
1. Bipolar Limb Leads:
Lead 1- Between right arm(-ve) and left arm(+ve)
Lead 2- Between right arm(-ve) and left leg(+ve)
Lead 3- Between left arm(-ve)
and left leg(+ve)
2. Augmented unipolar Limb Leads:
AvR- Right arm
AvL- Left arm
AvF- Left leg
3.Chest Leads:
V1 : Over 4th intercostal
space near right sternal margin
V2: Over 4th intercostal space near left sternal margin
V3:In between V2 and V4
V4:Over left 5th intercostal space on the mid
clavicular line
V5:Over left 5th intercostal space on the anterior
axillary line
V6:Over left 5th intercostal space on the mid
axillary line.
Normal ECG:
Waves of ECG:
P Wave
•P Wave is a positive wave and the first wave in ECG.
•It is also called as atrial complex.
Cause: Atrial depolarisation
Duration: 0.1 sec
QRS Complex:
•QRS’ complex is also called the initial ventricular complex.
•‘Q’ wave is a small negative wave. It is continued as the tall ‘R’ wave, which is a positive wave.
‘R’ wave is followed by a small negative wave, the ‘S’ wave.
Cause:Ventricular depolarization and atrial repolarization
Duration: 0.08- 0.10 sec
T Wave:
•‘T’ wave is the final ventricular complex and is a positive wave.
Cause:Ventricular repolarization Duration: 0.2 sec
Intervals and Segments of ECG:
P-R Interval:
•‘P-R’ interval is the interval
between the onset of ‘P’wave and onset of ‘Q’ wave.
•‘P-R’ interval cause atrial depolarization and conduction of impulses through AV node.
Duration:0.18 (0.12 to 0.2) sec
Q-T Interval:
•‘Q-T’ interval is the interval between the onset of ‘Q’
wave and the end of ‘T’ wave.
•‘Q-T’ interval indicates the ventricular depolarization
and ventricular repolarization,
i.e. it signifies the
electrical activity in ventricles.
Duration:0.4-0.42sec
S-T Segment:
•‘S-T’ segment is the time interval between the end of ‘S’ wave and the onset of ‘T’ wave.
Duration: 0.08 sec
R-R Interval:
•‘R-R’ interval is the time interval between two consecutive ‘R’ waves.
•It signifies the duration of one cardiac cycle.
Duration: 0.8 sec
Dimension of ECG:
How to find heart rhytm of the heart?
Regular rhytm:
Irregular rhytm:
More than or less than 4
How to find heart rate using ECG?
If heart Rhytm is Regular :
Heart rate =
300/No.of large b/w 2 QRS complex
= 300/4
=75 beats/mins
How to find heart rate using ECG?
If heart Rhytm is irregular:
Heart rate = 10×No.of QRS complex in 6 sec 5large box = 1sec
5×6=30
10×7 = 70 Beats/min
Abnormalities of ECG:
Cardiac Arrythmias:
1.Tachycardia
Heart Rate more than 100 beats/min
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30 Day Health
- 2. Annual hospital re-admissions in the US 50 million 20% will be readmitted within 30 days $ 17.4 billion
- 3. New patented technology improve patient management schedule early intervention reduce readmissions improve outcomes
- 4. Meet Bill 68 years old Congestive Heart Failure Discharged from hospital today The next 30 days are key to successful recovery
- 5. Doctor ’s recovery plan Doctor wants early mobility Needs to avoid prolonged bed rest Recommends 30 steps / day based on baseline level and similar recovery plans
- 6. How the system works STEP I Doctor defines baseline and sets goals for recovery STEP II STEP III Patient wears the 30day motion sensor (wireless tracker) all day Sensor and system seamlessly communicate with family members and doctors for 30days
- 7. Day 5 Bill spent long periods in bed with no activity System intervenes, notifies his daughter Daughter assist him to become more mobile First incident avoided… Day 20 Bill is short of breath; Reduced mobility System schedules consult; Doctor changes medicine dosage Breathing easier; Readmission avoided Outcome improved by early intervention
- 8. The big audacious goal 20,000 DECREASE PAT I ENT S EARLY READMISSION RATES REDUCE READMI T S BY 50% SAVE $17 M
- 9. Milestones SEPTEMBER 2014 Beta testing with first partner – confirmed NOVEMBER 2014 Introduce the technology to our other partners JANUARY 2015 Seek other suitable pilot projects FEBRUARY – MARCH 2015 Commence pilot projects with identified Clinics; Orthopaedic / rehabilitation specialists MARCH 2015- Move from pilot into live operations Expand into new regions (Europe, UK)
- 10. HOSPITALS INSURERS Business Case Licence Fee Per pat ient , per month Device Sales PROVIDERS
- 11. Outcomes BETTER PATIENT CARE SAVE HEALTH CARE SPENDING REDUCE PREVENTABLE READMISSIONS
- 12. The Team Simon Spur r Geof f Appelboom Nuno dos Ramos Co- founder S t r a t e g y g u y 1 2 y e a r s h e a l t h c a r e c o n s u l t i n g Co- founder Te c h g u y 1 0 y e a r s h e a l t h c a r e I n f o rma t i o n s y s t ems Co- founder Me d i c a l g u y MD P h D Ne u r o s u r g e o n