Clinical Requirements
Clinical Objectives
- Detect HF worsening earlier through multi‑modal ambient QoL trends.
- Track changes post‑therapy optimization (e.g., GDMT up‑titration) and events (ED visit, hospitalization).
- Provide clinician‑interpretable domains tied to actionable plans.
Clinical Content
- Domains: Physical, Emotional/Cognitive, Social/Behavioral, Symptom Burden, Environmental.
- Reference Instruments: KCCQ‑12 (adjunct); optional PHQ‑2/GAD‑2; PROMIS Physical Function (short form).
- Signals: Steps, HR/HRV, sleep, routine regularity, speech features (tempo, pitch var., pauses), geospatial breadth, noise/light, weather/air quality indices.
Validation Plan
- Design: Prospective cohort (n≈60–120) across NYHA II–IV.
- Endpoints: Correlation with KCCQ‑12 subscales; responsiveness to clinical change; predictive value for decompensation within 7–14 days.
- Stats: Target r ≥ 0.5 with KCCQ overall; AUC ≥ 0.75 for decompensation prediction.
- Safety: Clinical review of all Urgent alerts within 24h; DSMB‑like oversight for pilots.
Clinician Workflow
- Review domain trend cards (7/30/90d).
- Inspect recent alerts; acknowledge and choose plan (televisit, med adjustment, labs).
- Document action → writes FHIR
CarePlan/ServiceRequest or note export.