UC San Diego

Rehospitalizations for chronic diseases such as heart failure are common and costly. However, they are also preventable. In many cases, timely interventions can prevent the patient from reaching a critical point where hospitalization is needed. Since these decompensations occur necessarily in the patient’s home, home health solutions are an ideal choice to give clinicians insight into their patient’s well being and enable timely interventions. However, many home health solutions are limited by requiring adherence or technological literacy, or in some cases, an invasive procedure. We describe here a non-contact adherence-independent system for total body weight and cardiopulmonary monitoring in the home bed (BedScales). We describe the system design and present validation experiments. Additionally, we discovered that nocturnal respiratory rate (NRR) in particular is a very useful, yet understudied biomarker for detecting disease exacerbations. We therefore performed the first large-scale analysis of NRR from over 22,000 sleep studies and found that there is an association between NRR and chronic diseases such as atrial fibrillation, heart failure, and COPD. We installed BedScales devices in the homes of high-risk patients and monitored them for an average of one hundred days each. In doing so, we found instances where NRR rose from baseline in response to diseases such as sepsis, pneumonia, and heart failure. Finally, we present three case reports from patients we monitored with complex physiology, demonstrating how the BedScales platform and NRR would be able to greatly expand the window that clinicians had for performing a timely intervention. We believe that this approach to outpatient management will be able to, in a practical and widely applicable manner, allow clinicians to care for their patients at home and achieve the triple aim of improving care, improving quality of life, and lowering costs.