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Smiling Nurse Mary at TGH
Registered nurse Mary O’Sullivan holds up her phone with the Medly app on it. The app allows remote monitoring of more than 300 patients to one nurse. (Photo: UHN)

Registered nurse Mary O'Sullivan couldn't be happier to be managing the care of more than 300 cardiac patients.

Did that make you pause? Are you wondering how one nurse can manage that many people with chronic illness?

You would be right to think she has a little help.

Mary starts every day by opening up the dashboard of the Medly app, co-created by Dr. Joe Cafazzo, Executive Director of eHealth Innovation, UHN, and Dr. Heather Ross, Head, Division of Cardiology, Peter Munk Cardiac Centre.

For heart failure patients, the three most important metrics to measure on a daily basis are weight, blood pressure and heart rate. This set of numbers tells a story about how the patient is doing and whether they need immediate care to avoid serious complications.

Medly is a digital program that easily allows heart failure patients to measure these factors every day and submit them electronically to Mary who will then make assessments based on individual needs.

"This is a transformational model of care," says Mary, Lead Clinical Coordinator, Medly Remote HF Monitoring. "We're not just receiving data but we actually give feedback to the patients, in real time."

Mary stresses the point that the Medly program doesn't replace clinic visits but rather gives patients the safety net to take more control over the day-to-day management of their chronic disease. Medly is built to be safe, so if a patient's numbers are concerning, an alert will tell the patient to go to the Emergency Department and their care team will be notified.

The use of Medly has cut down both the number of Emergency visits and the length of stay when patients are admitted. Before the use of this app, patients would often wait until they were in a more serious state before seeking help. Now, as soon as data is submitted, Mary can be assessing people in real time and triaging their needs with their care team so that no one falls through the cracks. 

'Sophisticated AI can make Medly even better'

"Medly has extended my dad's life," says Judy Nyman. "If my dad wasn't using this app every day, I wouldn't know just from looking at him, how he's actually doing.

"Without the easy ability to have constant contact I'm not sure my dad would still be alive. I wish more people had access to this technology, because it is life-saving, I love this app."

Judy Nyman may just get her wish.

Soon, Medly may get a turbo boost in the form of an Artificial Intelligence (AI) algorithm that will go way beyond simple measurements into the world of predictive abilities. The initiative is being supported by the Vector Institute, an independent, not-for-profit research institute focused on leading edge machine learning.

Vector has chosen Medly to be one of a series of Pathfinder Projects aimed at bringing AI into practice in the health sector.

"We chose Medly based on the strength of Dr. Ross and UHN's cardiovascular team," says Alison Paprica, Vector's Vice President of Health Strategy and Partnerships. "It was also very important to us to have a health AI application that helps people stay out of hospital.

"Medly does that already, and sophisticated AI can make Medly even better."

Mary O'Sullivan says Medly is making a big improvement to the quality of life for patients.

"Heart failure doesn't just happen that one day in clinic," says Mary. "It's ongoing every day and this app allows patients to feel more in control. I'm proud to be able to help build up their independence."

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