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In-Home Cardiovascular Monitoring System for Heart Failure: Comparative Study

Author: Casana Research

Published: January 18, 2019

The study, In-Home Cardiovascular Monitoring System for Heart Failure: Comparative Study, authored by Nicholas J Conn PhD., Karl Q Schwarz MD., and David A Borkholder PhD., was inspired by the demand for solutions that can monitor heart failure patients in the home, and reduce hospitalization rates, as health care costs rise.

Under programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions. For the readmission penalties, Medicare cuts as much as 3 percent per patient. In the 2021 fiscal year, CMS (Centers for Medicare & Medicaid Services) will penalize 2,545 hospitals for having too many Medicare patients readmitted within 30 days, according to federal data cited by Kaiser Health News.

Reduction of hospital readmission rates is a constant endeavor, with the Hospital Readmission Reduction Program (HRRP) well into its ninth year of service. A potential solution lies in being able to track physiologic changes to detect early deterioration in the home and possibly reduce hospitalization rates through early intervention. Classical approaches to in-home monitoring have had limited success, with patient adherence cited as a major barrier.

In-Home Cardiovascular Monitoring System for Heart Failure: Comparative Study, presents and evaluates a prototype device – a toilet seat–based cardiovascular monitoring system (now referred to as The Heart SeatTM) that has the potential to address low patient adherence of traditional telemonitoring devices, as it does not require any change in habit or behavior. This monitoring system consists of an integrated electrocardiogram, ballistocardiogram, and photoplethysmogram capable of measuring systolic and diastolic blood pressure, stroke volume, and peripheral blood oxygenation.

Study Methods

“The toilet seat–based estimates of blood pressure and peripheral blood oxygenation were compared to a hospital-grade vital signs monitor for 18 subjects over an 8-week period. The estimated stroke volume was validated on 38 normative subjects and 111 subjects undergoing a standard echocardiogram at a hospital clinic for any underlying condition, including heart failure.” (Conn, Schwarz, & Borkholder, 2019)

The results of this study demonstrated that achieving clinical grade accuracy was possible for blood pressure, peripheral blood oxygenation, and stroke volume, when compared to their respective gold standards in the patient populations that participated in the study. Although this study was just the beginning of our clinical validation of The Heart Seat, Casana believes that this system will be uniquely positioned to capture previously unattainable health trends in the home, ultimately with the goal of improving patient outcomes and limiting rising health care costs, especially for those with Heart Failure.

Demonstration of the clinical benefit of this technology requires further development and study and studies are underway. To join Casana in researching the benefits of this technology please email or read more at

In-Home Cardiovascular Monitoring System for Heart Failure: Comparative Study is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium. This study is publically available through its publisher, JMIR Mhealth and Uhealth. JMIR Mhealth Uhealth 2019 | vol. 7 | iss. 1 | e12419 | p.1