Introduction
The spread of coronavirus disease 2019 (COVID-19) has seriously affected
the medical system worldwide. In addition to caring for patients
suffering from COVID-19, medical staff have faced difficulties in the
outpatient care of non-COVID-19 patients. Some hospitals have
temporarily closed their outpatient clinics because of COVID-19
clusters, and patients with chronic disease have tended to avoid going
to hospital for fear of contracting the disease. Avoiding regular
consultations at hospitals/clinics might result in the worsening of
chronic conditions. Currently,
there is a growing demand on the
part of patients and health care workers for remote monitoring
systems1, 2 that use digital technologies to
collect medical data from
individuals, thus eliminating the need to visit a medical facility in
person.
A
patch-type wireless, real-time electrocardiogram (ECG) monitor (Duranta;
ZAIKEN Co., Ltd. Tokyo, Japan) has been approved and already used as a
Holter ECG device in Japan.3, 4 Conventionally,
patients visit the hospital to have the Duranta attached. After the ECG
monitoring, the patients return to the hospital to remove the device.
The device is small (35 g) and attaches easily to the chest using two
electrode patches. We therefore thought that patients could attach the
device themselves and that the device could be sent via the postal
service between the hospital and the patients’ homes. This novel usage
of the Duranta would allow patients to share the telemetry ECG data with
their doctors without visiting the hospital or visiting less often.
Here, we
report the initial experience of
using the small wireless ECG
monitoring device and the utility of delivery via the postal service in
outpatient care in Japan.
Methods
We retrospectively analyzed the
data of patients who underwent long-term ECG monitoring at Kobe
University Hospital between August and December 2020 with the Duranta
device that was delivered via the postal service. The data including
patient characteristics, the method of delivery, ECG monitoring
duration, detection of arrhythmia, and any noises or signal interruption
during the ECG monitoring were
analyzed. In addition, we surveyed the patients to quantify their
satisfaction regarding the self-wearable ECG monitoring device delivered
via the postal service. The protocol for this research project was
approved by the Ethics Committee of Kobe University Hospital (Approval
no. B200276).