JEMS: Give us a basic overview of Medtronic’s ZephyrLIFE technology solution and what it does.

Medtronic: ZephyrLIFE home remote patient monitoring allows caregivers to monitor the physiological status of patients, as well as activity level, posture and position, in their own homes. At its core is the portable and secure HealthHub device that connects to several parameters and monitors vitals, including heart rate, respiratory rate, blood pressure, pulse oximetry, weight and glucometry.

Using cellular technology, the HealthHub then transmits the patient’s data to an online portal where clinicians can review trends, set alert thresholds and print reports. The system generates a comprehensive picture of a patient’s physiological status that’s contextualized over time. All data is securely stored in the United States and only authorized partners can access the data to integrate it into an existing emergency medical records system.

JEMS: How does this functionality assist with the delivery of EMS and the latest transformation for EMS into MIH-CP?

Medtronic: With mobile solutions like the ZephyrLIFE home remote patient monitoring system, EMS caregivers can now deliver proactive patient care and monitor patients in their own homes; this data can be invaluable in assessing a patient’s health. Deteriorating conditions can be identified remotely and care may be sent before the patient deteriorates to a point where an ED visit is necessary. Remote patient monitoring also allows working with patients and their care circle during recovery post-discharge and may help create an environment of trust between the community paramedic and the family.

For example, when a patient who’s being monitored at home with the Zephyr Biomodule—a patient-worn device about the size of a silver dollar—experiences a period of tachycardia, the alert is accompanied by a 30-second ECG rhythm strip where the clinician can visually identify arrhythmias, enabling immediate attention of the greater clinical care team. (See Figure 1, below.) Key features include:

  • Wireless ambulatory monitoring throughout the entire care continuum;
  • Monitoring changes in heart rate and respiration rate;
  • Monitoring changes in activity level and position;
  • Ability for clinicians to request and review ECGs and alert history;
  • Collecting and displaying episodic data (e.g., blood pressure, SpO2, weight, blood glucose and temperature);
  • Ability for patient and members of the care circle to log in and review data;
  • Alert thresholds set on a patient-by-patient level;
  • Easy visualization of patient non-compliance; and
  • Remote access to patient data by the healthcare team.

JEMS: What’s your vision on EMS’ transformation of this service delivery model and the enhanced role Medtronic and products like the ZephyrLIFE system may play in the future to assist with the overall integration of EMS into the larger healthcare system?

Medtronic: Currently, MIH-CP systems assist with filling the gaps within the health-care system by utilizing their unique resources and experience within their communities. Many successful programs have focused on helping decrease 30-day hospital re-admissions and chronic disease states that cause these re-admissions. ZephyrLIFE remote monitoring could play an important role in the future to assist MIH-CP systems to better utilize their fixed assets (i.e., people, vehicles, etc.) while still providing the desired outcomes of the triple aim: improved patient outcomes, increased patient satisfaction and lowered costs. It also helps to coordinate communication between the members of the healthcare team and the patient.

Figure 1: Zephyr Biomodule

Monitoring MIH-CP patients remotely enables pre-hospital providers to better provide quality care.

MedStar is launching a demonstration project testing the ZephyrLIFE technology on 30 patients enrolled in their re-admission prevention program. The Remote Patient Module will be monitored in MedStar’s communications center by triage nurses and, when nurses aren’t on-duty, by emergency medical dispatchers. The goal of the demonstration project is to see if the use of the ZephryLIFE technology can improve patient safety by identifying hemodynamic issues with enrolled patients in between home visits. A secondary evaluation will test if we can improve patient outcomes while reducing the number of actual scheduled or episodic home visits.

JEMS: What patient populations would most benefit from remote patient monitoring?

Medtronic: Patients who’ve been discharged from the hospital and have disease states that can cause deterioration and re-admissions (congestive heart failure, diabetes, chronic obstructive pulmonary disease); patients who are highly active and don’t want to be tethered to a monitoring system; and patients whose activity minutes need to be tracked to ensure their daily activity is sufficient for recovery.

JEMS: Do you offer hospitals or stand-alone EDs a similar remote patient monitoring solution?

Medtronic: Yes, the ZephyrLIFE hospital system uses our proprietary ECHO radio system—a standalone radio that’s easy to install, provides coverage for up to 50 patients, and can monitor respiratory rate, heart rate and body position. In addition, the Vital Sync Virtual Patient Monitoring Platform allows clinicians to remotely view patient information from multiple devices (ventilators, capnography monitors, pulse oximeters, depth of consciousness monitors and regional oximetry) on any Webenabled device and send this information to the electronic medical records and Clinical Information Systems.

JEMS: Who’s using ZephyrLIFE technology?

Medtronic: Medtronic has agreed to provide Geneia with rights to sell its ZephyrLIFE remote patient monitoring solutions in designated markets as part of Genia home to monitor patients with heart disease, diabetes and other chronic illnesses in the home setting. Patients use the ZephyrLIFE home remote monitoring device to record their vital signs on a daily basis, including weight, pulse, blood pressure, blood oxygen level and blood glucose. Geneia merges this patient data with administrative and clinical data sets to provide an early warning about patients at risk and trigger the deployment of early intervention strategies such as telephonic support and home visits by clinicians.

As a result, the ZephyrLIFE home system is able to help Geneia reduce hospital admissions, re-admissions, observation bed days and ED visits; ensure appropriate medication usage; improve adherence to recommended preventive care; improve coordination of care between the patient and their physician; and enable and engage patients and the people in their support system to participate in managing their health and well-being.

Geneia recently announced that Capital BlueCross, a $3 billion health plan with over 700,000 members, is the first of the Blue plans to pilot Genia home to monitor patients with congestive heart failure.

Holly Stewart is the director of EMS sales and marketing at Medtronic. She can be reached at [email protected].