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Development of an automated remote monitoring system for outpatients

Development of an automated remote monitoring system for outpatients

The developed solution is designed to control and monitor whether the outpatients adhere to the physician’s orders. Auriga’s customer—a newly born startup—aims to engage patients to reduce preventable hospital readmissions, cut costs, and avoid penalties for denormalization. The startup was founded by highly professional representatives of the medical device manufacturing industry. 

The process stages are as follows: Upon discharge, the physician fills in a standard questionnaire and recommends necessary procedures (prescribed medications; diet; measurements of weight, blood pressure, temperature, etc.). The patient’s profile is registered in the database (DB) system, and the patient is assigned a so-called MediCoach, a relative or volunteer who will monitor the patient’s adherence to the schedule.

Every day, the patient receives several notifications: a full list of procedures describing the manipulations and time in the morning as well as reminders right before the procedures are to take place. In response to a notice, the patient must send a message in the format specified in the notification (e.g., note indicating that medication has been taken, measurement results). If the answer is correct, the system automatically recognizes it and adds it to the DB. If the received response is not recognized automatically the first time, the system sends a notification to the patient requesting another response. If the correct response is not received, the situation is escalated to the system maintenance company, physician, hospital, and MediCoach.

From a technical standpoint, the solution represents a distributed multi-tier system consisting of several components:

  1. Servers in hospitals and system maintenance company
  2. Global server and database allocated in MS Azure cloud
  3. Web-based client applications—for hospitals, patients, MediCoach, system maintenance company
  4. Mobile device applications based on Android and iOS platforms

The system supports the following notification formats: SMS, email, phone calls. In addition, the system generates a series of customizable reports: by the hospital itself, by medical departments, by patients with diverse diagnoses, etc. Our customer plans to integrate its solution with the US hospital-wide information system Iguana—the largest patient DB—allowing physicians to access US patient records regardless of their place of treatment.

The Dedicated Development Center (DDC) established for our client performs the project according to Agile methodology, in close day-to-day contact with the customer. A playable prototype was designed in less than two months and was demonstrated at several major industry-specific exhibitions and conferences in the United States. Each time, the customer gave the team detailed post-event comments and suggestions from real-time users and event visitors as well as recommendations for improvement and further modification of the application. Such close and transparent communication with the customer not only reduced the development time but also gave Auriga engineers a chance to feel like real application creators, to be aware of customer plans, and to present their ideas and solutions (i.e., to become an associate of the customer).

Tools & technologies: ASP.NET 4.5 MVC 4, WCF, EF6, MS SQL, JQuery, JQuery Mobile, SendGrid, Twilio

Name: Development of an automated remote monitoring system for outpatients
Tags: case study, project, product R&D, software development, healthcare, medical devices, prototyping, Agile, Android, web

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