Remote Monitoring of the Health Status of Pregnant Women at Risk for Preeclampsia

Remote itoring of the Health Status of Pregnant Women at Risk for Preeclampsia. The article presents the practical application of telemedicine information technologies that have allowed maternity institutions of the Sverdlovsk region to carry out remote monitoring the health of patients during pregnancy with hypertension and at risk for preeclampsia.


Registration in the System "AIST_SMART"
To register the patient in the personal account at the initial appointment of a pregnant patient, a consent-instruction [1] is issued to connect to the mobile service "AIST_SMART" with an individual QR code. At home, the patient reads the QR code using the camera of her smartphone or tablet and, according to the instructions, undergoes the registration procedure, forming a digital four-digit PIN-code. From now on, it is guaranteed 24/7 technical support. The QR code serves as the patient's identifier and the link between her electronic medical record (EHR) in the AIST "RAM" and the personal account in the "AIST_SMART" system.
To register a doctor in your personal account, you must log in to the medical information system -AIST "RAM", in which all medical personnel of the obstetric service in the region work. Open the "Personal Account" tab and register by scanning an individual QR code. So, in order to access electronic self-control diaries, the doctor and the patient connect to the AIST_SMART service, and after registering in the system, notifications about the results of remote health monitoring will be received on their mobile device.
The doctor does not need to call on the phone to find out how she feels, what her blood pressure, temperature, etc.

Formation of Notification of the Result of Self-Control Diaries
This process is fully automated. AIST_SMART performs the role of an intellectual assistant to the obstetrician-gynecologist/ midwife. The patient fills in the diary data, and the doctor receives ready-made results with automatic interpretation. Now the patient will not forget her paper diary at home, and the doctor will be able to make decisions on the tactics of management, taking into account not only the data on a face-to-face visit, but comprehensively taking into account the results of the patient's home self-control, which is important when selecting antihypertensive therapy in patients with arterial hypertension.

Pregnancy with Arterial Hypertension and at Risk for Preeclampsia
All patients in this category should carry out home monitoring of blood pressure with keeping a diary [2]. The self-control diary can be kept both by filling out the extended web-form of the diary, and by means of a chatbot in AIST_SMART, where the patient can send data in the format of a simple message: "pressure 120 70" and the service automatically recognizes, processes the data and records them in her personal account. If deviations of blood pressure above the norm are detected, AIST_SMART will automatically offer the patient a further algorithm of actions:   In the absence of indications for hospitalization, the results of the remote consultation are sent automatically to the attending physician of the antenatal clinic. Subsequently, the attending physician within the framework of the next outpatient visit will be able to track the patient's condition, the effectiveness of the prescribed antihypertensive therapy, viewing trends in diaries, and adjust the therapy based on a comprehensive analysis. If a decision is made on the need for hospitalization, the doctor of the ADC through a confidential "working" chat in AIST_SMART can contact the patient and clarify her consent to hospitalization and the possibility of transportation by personal transport. If consent is obtained (Figure 8), the doctor of the ADCC draws up an additional referral for (re-) hospitalization to a particular obstetric hospital, taking into account the level of MO and the location of the patient.

You do not Need to Receive a Paper Direction
If necessary, you can print the direction at the place of treatment of the patient, using a single information space of the regional obstetric monitoring of AIST "RAM". All the directions that a woman

Advantages of Remote Monitoring of Health
The transition to electronic diaries of self-control allows you to identify complications of the gestational process in the case of arterial hypertension and timely send the patient to hospitalization to prevent adverse events, which is from the main directions of the quality management system and safety of medical care. AIST_