Parole chiave
Remote Patient Monitoring
Telemetry
Family Medicine
Smartpatch
Nursing home
Healthcare Costs
Primary care
cost optimization
Abstract
Telemedicine is rapidly expanding, yet its integration into family medicine remains uneven due to organizational and regulatory barriers. Wearable devices enabling continuous monitoring of physiological parameters offer new opportunities for remote clinical assessment, particularly in frail nursing home residents, where hospital transfers are frequent and sometimes avoidable.
We report the case of an 89-year-old woman with multiple comorbidities who presented with acute asthenia. Examination revealed severe bradycardia, and electrocardiography showed complete atrioventricular block without ischemia. A drug-related cause was suspected, and beta-blocker therapy was discontinued. Given hemodynamic stability, hospital transfer was deferred, and continuous monitoring was initiated using a wearable telemetry device.
Over three days, persistent third-degree atrioventricular block with worsening bradycardia was documented. This enabled a targeted hospital transfer for pacemaker implantation, followed by rapid discharge back to the nursing home.
Wearable telemetry may enhance primary care decision-making, supporting safe community management and improving the appropriateness of hospital referrals in frail patients