A Florida doctor has invented a way to monitor patient pacemakers and defibrillators remotely from an Apple iPad in real time.
Dr. E. Martin Kloosterman, director of the electrophysiology laboratory and chief of the cardiology department at Boca Raton Regional Hospital in Florida, developed the Remote-K-viewer to allow doctors to see direct readings from pacemakers or defibrillators, which are implanted into the chest to treat irregular heartbeats.
Kloosterman refers to his method as "guided reprogramming." Although the iPad app can view the real-time readings from a cardiac device, it doesn't directly control it. The Remote-K-viewer iPad app communicates with a programmer, or touch-screen wireless laptop, that controls the cardiac device through a wand, creating a telemetry or transthermal connection.
"The wand is what interfaces with the cardiac device on top of the surface of the skin of the patient," Kloosterman told eWEEK. "And now you can see what the pacemaker or defibrillator is seeing in the programmer."
The iPad connects to the programmer through an encrypted Internet connection.
Kloosterman mainly tested the method in the hospital's emergency and operating rooms.
For the system to work, the patient must be in a medical facility, but the doctor can remotely monitor cardiac device information from anywhere using an iPad, desktop or laptop. He even tested the system using his iPad on a Virgin Atlantic flight from San Francisco to Orlando over WiFi.
Remote-K-viewer can display readings from pacemakers or defibrillators manufactured by Boston Scientific, Medtronic and St. Jude Medical.
By using the app, doctors would no longer require a representative from the device's manufacturer to be present when reprogramming a cardiac device, said Kloosterman. The representative would be an intermediary between the device and the cardiologist or electrophysiologist to discuss program changes to the pacemaker or defibrillator.
Remote-K-viewer also eliminates lag time in getting instructions from a doctor. With the physician connected on an iPad, the new process to program a cardiac device takes only a few minutes and allows doctors to respond to patient discomfort quicker, said Kloosterman.
"With this approach, you have instant access to the device situation without the need of a technician," he said.
"One of the things I learned is the relevance of real-time information," said Kloosterman. "And that brings things to a completely different stage in terms of how we practice medicine-different from getting a phone call and the need to return a phone call when the thing rings and now you need to take action on it."
Development of electronic health records (EHRs) and the iPad have led to the ability to remotely access vital data and inspired Kloosterman to develop Remote-K-viewer.
"The iPad provides you with essentially a parallel connectivity," said Kloosterman. "Either you use WiFi or a cellular line but you're connected, and that is a range you cannot get with other technologies."
Kloosterman says he tested Remote-K-Viewer on an iPhone, but the screen was too small to get a practical view of cardiac activity.
As for Google's Android or Research In Motion's BlackBerry, Kloosterman hasn't tested the app on those devices and is unsure if the devices would support the program.
The doctor on the iPad communicates with nurses or nonspecialized physicians with minimal training operating a dedicated cart. These onsite nurses or physicians make the manual changes to the cardiac device. Changes may include whether to give a jolt to the defibrillator to reset the heart rhythm, said Kloosterman.
"You can really gain diagnostic data collected in these devices regarding potential malfunctions or arrhythmia in real-time fashion, and that is very important," said Kloosterman.
Kloosterman has published an abstract of his study in the Journal of Cardiovascular Electrophysiology.
The current generation of Remote-K-Viewer is for research purposes only. Because it will not be a commercial product, Kloosterman doesn't plan to submit the method for FDA approval.
"This one I did in my garage; the next generation I couldn't," said Kloosterman.
Patients have been receptive so far.
"Today any nurse is hooked to a computer to do anything, and therefore it comes in a more natural way," Kloosterman explained. "If we can control a robot in Mars, we can certainly control remotely a cardiac device in Boca Raton."