Missing Data of the Philips HealthDot: insights into monitoring at home and level of physical activity

Rationale: Continuous vital sign monitoring of patients after colorectal and pancreatic resections is crucial for assessing health status and enabling the early detection of potential deterioration. The Philips Healthdot, a wearable designed for post-discharge patient monitoring, uses accelerometer measurements to track heart rate (HR), respiration rate (RR), and patient activity, and transmits the data through the Long Range (LoRa) network. Data loss or periods of missing data can affect the effectiveness of this monitoring strategy compromizing patient safety. This study evaluates the extent of HR and RR data loss from the Philips HealthDot in both home and hospital settings.

Methods: To quantify HR and RR data loss, thirty patients who underwent oncological colorectal or pancreatic resections were monitored with the HealthDot for 14 days. The percentage and duration of missing HR and RR data were retrospectively determined both inhospital and at-home. Data loss was classified as either non-transmission via the LoRa network or as missing values within transmitted data. The relationship between activity level and missing HR/RR values in transmitted data was analyzed using Students’ t-test.

Results: From all thirty patients, 36.5% of RR and 43.8% of HR data was missing. Nine patients experienced more than four consecutive hours of missing data, with five of these patients missing data for more than nine consecutive hours. Over the entire monitoring period resulting in 116239 time datapoints, 30339 (26.1%) time datapoints were not transmitted via the LoRa network. In-hospital, the percentage of missing values in the transmitted data was 2.0%, whereas at home, it was 38.1%. Higher activity levels, such as walking, were significantly associated with the loss of HR and RR data in transmitted data (p<0.001).

Conclusions: Missing HR and RR data is closely linked to LoRa network transmission limitations and patient activity levels. Implementing the HealthDot for at-home monitoring may reduce the capacity to detect and respond to patient deterioration, potentially compromising patient safety. Therefore, combining the healthdot with patient-reported measurements is advisable until improved remote patient monitoring solutions are available.