## 5 Remote Monitoring Technologies
From there, the processed data can be accessed by relevant medical practitioners, and incorporated into the hospital information system. The processing centre can also send the data on to the clinical team responsible for the device using email, fax, SMS, _etc._ In addition to scheduled transmissions, e.g., daily or weekly data transfers, a failure in the performance of the indwelling device or worsening of the patient's condition prompts an emergency data transmission to the server and subsequent notification of the medical practitioner associated with the device. The early detection prevents or minimizes the negative consequences of the event and increases the patient's chances for survival and recovery [111]. Furthermore, by analyzing data preceding an emergency event, medical practitioners can identify the patterns and thus predict and potentially mitigate events leading to hospitalization. For example, 123 patients implanted with cardiac resynchronization therapy devices with embedded Home Monitoring capability were monitored over 12 months, at the end of which the data collected using remote monitoring system was retrospectively analyzed against re-hospitalization and other clinical events [109]. The transmitted data embraced several potential predictors of death or hospitalization, including the onset of atrial and ventricular arrhythmias, extent of physical activity, mean heart rates over 24 h and at rest, extent of cardiac resynchronization therapy delivered to the patient, and device lead impedances. The study found that in 70% of the re-hospitalization cases, there was an increase in mean heart rate at rest and in mean heart rate over 24 h within 7 days preceding the event. In 30% of re-hospitalized patients, there was a notable decrease in the duration of daily physical activity, and in 43% of re-hospitalization incidents they were preceded by a reduction in the percentage of resynchronization therapy delivered. Early detection of these patterns and timely response is likely to result in a significant reduction in a number of hospital re-admissions, duration of hospital stay, and patient mortality. The benefits of employing the wireless body area network to advance healthcare quality are undoubted, from ongoing health surveillance and patient- and progress-tailored rehabilitation to emergency response systems and large-scale longitudinal medical and spatio-temporal social studies [112,113]. Wearable sensors have been used to monitor motor fluctuations in patients suffering from [PERSON]'s disease, including estimating the severity of tremor, bradykinesia and dyskinesia from accelerometer data features [114,115]. Compared to clinical visual observations, the sensor network was able to accurately quantify the severity of the tremors with 87% accuracy, separating resting and postural tremors, and discriminating tremors from other Parkinsonian motor symptoms during daily activities [115]. In the case of major emergency events, e.g., natural mass-casualty disaster, computer-enabled monitoring of clinical statuses of patients can facilitate prioritization of medical help to those who need it most, which can potentially save many lives [116,117]. In general, the requirements for the sensor network will be influenced by the spatial and temporal scopes of the study, the number of individuals/sensors for which the network is required, and the nature of the wireless networking and sensing technologies that are being employed [113,117]. For instance, availability of power and ergonomics of the system become more important as the temporal scope of the study increases, whereas increasing the spatial scope such as in the case of epidemics study will impact on the choice of communications infrastructure. For instance, miTag is a cost-effective scalable wireless sensor platform developed to automatically track patients throughout the disaster response process, from the scene through to ambulance and clinic [118].