REHAL®, a telemedicine platform for home cardiac rehabilitation.

Aim. The new REHAL platform manages home-based cardiac rehabilitation programmes without most of the drawbacks of an earlier E-Remedy EC proposal . The proposal is based on the awareness that safe home rehabilitation is only possible in the post-hospital phase when the patient no longer needs direct control by medical staff and has become accustomed to the technological set-up. Methods The platform is composed of a web-based database and client software (Ergomonitor), which allows health staff to manage the sessions without a real-time connection and legal liability. Ergomonitor permits the complete management of a bike (training session settings, web transmission and data recording) by a serial connection to a PC. Patients own their data and may approve the access of health personnel to evaluate the results and introduce longitudinal ambulatory information together with updated physical activity protocols. The health service does not bear the cost of the technological set-up. Ergomonitor acquires and records heart rate, loads, pedalling speed and other parameters of interest (i.e. arterial pressure) and forwards data to a remote database. Health personnel can modify time by time the scheduled exercise settings, analyse the results of each session and compare session by session. Results The platform is actually used in hospital, gymnasium and home context. More than 1000 subjects have been enrolled in the protocol, with a very good appreciation. A representative case study is reported. Conclusions The first experience of REHAL (six months, more than 1000 enrolled patients) highlights the positive aspects of the solution: the patients are very satisfied with the continuity of the rehabilitation programme and the clinicians are very satisfied they can follow their patient population longitudinally and with a personalized protocol.