The chief of the cardiology department at 400-bed Boca Raton Regional Hospital in Florida has developed software for controlling heart devices remotely using an iPad, The hospital’s executives say the technology could revolutionize the way physicians reprogram pacemakers.
E. Martin Kloosterman, MD, director of the electrophysiology laboratory at the hospital, published his study in the peer-reviewed Journal of Cardiovascular Electrophysiology, and he presented his findings at the Venice 2011 Arrhythmias international workshop to more than 1,700 physicians on Oct. 9.
“This new development provides clinicians the ability to manage cardiac devices, such as pacemakers and defibrillators, remotely in real-time,” Kloosterman said. The model, which was tested in the hospital’s emergency and operating rooms, allows the specialized physicians to have direct access to the information in the patient’s device for adjustment and reprograming in a moment’s notice no matter where they are and at any given time.”
Kloosterman explains how devices are reprogrammed today: Cardiac device systems require the presence of the manufacturing company’s representative and the use of a programmer (a dedicated computer that communicates with the cardiac device to obtain data and perform testing and programming changes). Once at the patient’s bedside, the representative gathers the data and then communicates the findings to the cardiologist and/or electrophysiologist to determine any program changes. A device check can take hours, and not having clear, firsthand information by the physician leads to unnecessary lag times.
Kloosterman said he first came up with the idea for real-time programming several years ago.
“First, the evolution of the electronic medical records disseminated computer terminals with Internet connections in the medical work space allowing clinicians ready access to patient information,” he said. “Then recently, the iPad emerged providing the ability to be online in seconds anytime, anywhere, allowing remote access to computer information. The combination of these two new innovations led me to the creation of the new technology: the remote-K-viewer."
Kloosterman designed and build a cart that hosts the programmer connected to a touch screen laptop with a wireless internet connection and a printer. The remote-K-viewer cart is mobile and designed to be used by nurses or non-specialized physicians with minimal training.
On the other end, this new application allows the specialized physician to remotely access to a direct visualization of the programmer screen seeing the patient’s pacemaker or implantable cardioverter-defibrillator (ICD) information from an iPad on the road or on a computer at the office or at home. A nurse at the bedside follows the remote physician instructions to operate the programmer via telephone communication and the laptop attached to the programmer.
The entire process takes just a few minutes, Kloosterman said.
As part of his recent publication on this topic, Kloosterman reported the testing of his system during an airplane flight from San Francisco to Orlando. The system has also worked well with communication from out of the state and in South America and Europe.
“The remote-K-viewer concept is a new software/hardware communication system and the first step into an inevitable direction, real time remote device management," he said. “We are excited with the possibilities that this application has to offer in regards to the development of a new generation of programmers and service models in the near future. If we can control a robot in Mars we can certainly control remotely a cardiac device in Boca Raton.”
