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For close to a decade, cardiologist Professor Sze-Yuan Ooi was responsible for implanting cardiac devices in as many as 300 patients a year, and remotely tracking their ongoing performance. He knew that the system being used, featuring a flashing bedside device, was a source of anxiety for his patients, leading him to wonder if there wasn’t a better way.

Sze-Yuan connected with Scientia Professor Nigel Lovell, Head of the School of Biomedical Engineering, and within a short amount of time the TeleClinical Care (TCC) app was designed, built, and trialled, demonstrating a 50 per cent reduction in cardiac hospital readmissions.

The TCC app makes it possible for a range of physiological measurements to be taken from the patient in their own home with minimal disruption, and sends that information back to clinicians for assessment and management. The continuous flow of information means that clinicians can often detect issues before they develop into serious problems, and contact their patients to arrange appointments or further treatments as necessary. The app can also track medication compliance, deliver behavioural and exercise programs, provide psychological support, and offer patients access to educational resources. 

TCC in the pandemic

When the COVID-19 virus emerged at the start of 2020, highly infectious and with no immediate vaccine or treatment solutions available, it was obvious to the TCC team that their product’s remote monitoring capabilities could be of use. In close collaboration with the South Eastern Sydney Local Health District (SESLHD), the app was adapted for use during the pandemic, and ultimately made it possible for 8,000 COVID-positive patients to be remotely monitored and cared for at home. It slowed the spread of the virus, and made it possible for hospital staff to focus on the most serious cases only.

The pandemic provided an opportunity to test the app at scale, informing some improvements in the technology, but also in the way it integrates with clinical workflows. According to Nigel, the team is now working with Microsoft to embed its video conferencing platform into the app to enable routine ‘virtual check-ups’, a development that could profoundly improve the quality of care experienced by people in rural and remote areas where the nearest hospital is many hundreds of kilometres away. They’re also exploring how they can use predictive analytics to assess patient risk and support the prioritisation of in-person care for those in serious need of hospital-based support.

A golden opportunity for TCC

In recent years, versions of the app have been developed for neonatal care, and to support people recovering from stroke or managing gestational diabetes. There have been successes across all these areas, but Nigel flags the development of a multi-purpose app, tentatively labelled TCC-360, as the next step.

“What is typically done in telehealth is that people say, ‘Okay, I'm going to monitor someone with heart failure or COVID or chronic lung disease’ – but people don't fit into those boxes. If you’re looking at people over 65, more than 50 per cent will have two or more chronic morbidities, so it's highly likely they won't fit into a single box.”

Nigel’s colleague, Sze-Yuan, shares the ambition, adding: “We want to have one app that clinicians can use to prescribe the functionality their patient requires, in the same way they prescribe medications. It's personalised medicine, but in the form of a personalised app to address the individual patient’s conditions and needs.”