MC-SAT: A Telemedicine Management System Utilized to Monitor Oral Vitamin K Antagonists Treatment

• Published in: Blood 2011-11, Vol.118 (21), p.4742-4742
• Main Authors: Iosub, Diana Irina, Marisa, Barone, Beltrametti, Chiara, Barco, Stefano, Chiara, Picchi, Paolo, Cristiani, Sabatini, Fabio, Piovella, Franco
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V118.21.4742.4742

Abstract 4742 The MC-SAT program is a telemedicine system developed for the management of patients under oral anticoagulant treatment (OAT). The program constitutes the natural evolution of an original research project, which assessed the capability of a telematic system in managing different chronic patients access flow to health care services. In particular, for patients on oral anticoagulation we planned a direct access to a call center server and a pre-process of the INR data obtained through self-testing with portable prothrombin time (PT) monitor. The original project performed the technology assessment of all the devices and procedures able to automatically drive international normalization ratio (INR) data from patients to specialists in a hospital anticoagulation clinic and to get patients able to read the medical answer. The ability of patients and/or general practitioners to self-determine INR without specific training and the integration of a portable PT monitor for home use into routine patient care in anticoagulation clinics was subsequently successfully evaluated. After a pilot phase of the project, during which the feasibility of the MC-SAT telemedicine service was assessed, we started the enrollment of consecutive patients. Controls matched by age (+/− 5 years), sex and therapeutic range with the cases, were selected among those who attended our anticoagulation clinic (whose population reaches 3,557 individuals) and were managed by usual care. At the beginning of the program, which is still ongoing, a portable monitor (Coagucheck®, Roche Diagnostics, Germany) has been given to 40 patients and to 10 general practitioners (GPs) provided with portable monitors and Internet access. Each GP had the task to follow 5 patients on chronic OAT. Subsequently, additional 40 patients joined, referring to the preferred community laboratory to perform the prothrombin time and subsequently send the INR results through MC-SAT. To date, the system works like this: the INR data, obtained through the portable monitor or through a local laboratory, is sent by GPRS cellular phone or by Internet computer. When an alert output is detected, an automatic message is sent to the specialist. GPRS services are implemented in order to connect the specialist to the database containing the clinical history of the patient. The specialist is able to monitor, from any location, by means of smartphone or tablet PC, all INR values recorded by the system, all the previous patie