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FDA approves nation's first eye-implanted telescope to treat blindness
U.S. Food and Drug Administration officials have approved a first-of-its-kind technology—a tiny telescope implanted inside the eye—to counter incurable age-related macular degeneration (AMD), the nation's leading cause of blindness in older adults. According to Allen W. Hill, chief executive officer of Saratoga, CA-based VisionCare Ophthalmic Technologies Inc., the Implantable Miniature Telescope's magnification capability reduces the impact of the blind spot caused by end-stage AMD. Smaller than a pea, the telescope is implanted in one eye in an outpatient surgical procedure. In the implanted eye, the device renders enlarged central vision images over a wide area of the retina to improve central vision, while the nonoperated eye provides peripheral vision for mobility and orientation. A total of 90% of patients in a 219-person study had their vision improved with the device; VisionCare will conduct a postapproval study to monitor patient outcomes under commercial conditions, Hill said.
Despite recession, medical imaging market to post 14% gain by 2012
The medical imaging market is expected to recover from the adverse effects of the economic downturn and the significant decline in reimbursement, and generate more than $6.5 billion worldwide by 2012, according to a report by market research firm Frost & Sullivan. According to Frost & Sullivan research associate Simone Carron, the revenue upturn—a 14% increase from the $5.7 billion posted in 2009—will be driven by “advancements in technology and new clinical applications for imaging modalities,” including hybrid systems with innovative developments such as radiation reduction and better temporal resolution. Market segments covered in the report include computed radiography and digital radiography (CR and DR), magnetic resonance imaging (MRI), computed tomography (CT), three-dimensional (3D) and computer-aided design (CAD), ultrasound, C-arms, imaging informatics, contrast media and auto injectors, mammography, molecular imaging, and nuclear medicine.
New ECG sensor can detect heart and brain activity without touching skin
Researchers at the University of California at San Diego have developed a medical sensor that can read electrocardiogram (ECG) and other data through clothing, without ever touching the skin. According to UCSD graduate student Mike Chi, who created the device with UCSD bioengineer Gert Cauwenberghs, traditional ECG electrodes detect the time it takes for waves of changing polarity caused by heart-muscle contractions to travel to different sensors, which reveals the electrical activity of different parts of the heart. The sensors are messy, allergy inducing, uncomfortable, and motion sensitive, and can't be used outside the clinic or for long periods. But the UCSD sensor, slightly larger than a quarter, can detect faint changes in capacitance and amplify them, while canceling out ambient electrical noise. Multiple sensors embedded in material and wired together create a portable monitor that patients can wear over clothing during their daily routine. This could mean increased monitoring time and better compliance from patients, Chi said. Incorporating the sensors into a headband could also make it possible to monitor electrical activity in the brain. Chi is creating a startup company, Cognionics, to develop the sensors further, and has already begun talks with medical device companies.
Veterans Affairs starting to build prototype of mobile MyHealtheVet
The Department of Veterans Affairs (VA), in an attempt to improve the health outcomes of veterans, is exploring wireless technology applications with a particular focus on rural areas several hundreds of miles from the closest VA clinic or hospital. One project is a prototype mobile version of MyHealtheVet, the VA's online personal health record (PHR). The project would make the VA's PHR available via mobile phones. To date, the VA has installed very small aperture terminals (VSATs) on its 50 mobile veteran centers to allow satellite communications. These efforts are part of a broad group of changes the VA is making to how it approaches care delivery. The plan involves designing new systems around the needs of patients and attempting to improve care coordination and online access using wireless and digital technology such as secure messaging, social networking, and telehealth.
Broadband projects awarded $795 million in latest round of federal grants
The Obama administration has announced $795 million in grants and loans for 66 new broadband projects across the country, including $62.5 million to a group of national research and education networking organizations to link libraries, schools, and other organizations and offer the capacity for high-bandwidth applications like telemedicine and distance learning. The funding, matched by $200 million in outside investments, is part of the $7.2 billion included in the 2009 federal economic stimulus package to expand broadband access nationwide. President Obama said tens of millions of Americans and more than 685,000 businesses, 900 healthcare facilities, and 2,400 schools in all 50 states stand to benefit from the awards. About one-third of the funding has been awarded. A complete list of the newest recipients is available at
Covidien to buy Somanetics for $250 million, move into patient monitoring
Medical device maker Covidien PLC plans to buy patient monitoring equipment maker Somanetics Corp. for $250 million, the companies announced. According to Pete Wehrly, president of Covidien's respiratory and monitoring solutions unit, Covidien will pay $25 in cash per Somanetics share. The merger will “expand Covidien's presence in the operating room,” Wehrly said. Somanetics had sales of $50 million in 2009 and has 150 employees. The Troy, MI-based company makes a patient monitor that measures blood oxygen levels in the brain and in the body of patients who are at risk for restricted blood flow, allowing clinicians to detect and correct various life-threatening complications. Covidien, based in Ireland, has 42,000 employees worldwide in more than 60 countries and posted revenue of $10.7 billion in 2009.
Neuros Medical receives $1.5 million from DoD to treat amputee “stump” pain
Willoughby, OH–based neurostimulation medical device maker Neuros Medical Inc. has received a $1.5 million grant from the U.S. Department of Defense to develop a drug-free treatment for chronic residual limb pain or “stump” pain, experienced by nearly 1 million amputees. According to Neuros Medical president Jon J. Snyder, the company's Nerve Block technology—consisting of a pacemaker-sized generator and electrode—uses high-frequency alternating-current stimulation to block chronic pain signals in the peripheral nervous system. Military casualties and amputations experienced by those serving in Iraq and Afghanistan have increased the need to develop effective treatments for patients suffering from chronic residual limb pain, he said.
Domestic medical travel could derail telemedicine's market growth
Telemedicine may have an unexpected barrier in its efforts to become a medical care method of choice. According to a report in USA Today, more employers and insurers are offering financial incentives to encourage workers to consider traveling to specialists for the care they need. The use of “domestic medical travel”—in which workers are sent to facilities with high-quality care and lower prices—can help employers reduce their costs from 20% to 40%—more than enough to cover the travel expenses. Employers with domestic travel programs say they save money in part by negotiating a single rate, which includes fees for surgeons, anesthesiologists, and all medical care up until the patient is discharged, according to the report. Although it is promising, the concept could backfire if employers and insurers focus solely on cost rather than quality, USA Today notes.
Doctors, insurers using software to simplify medical jargon for patients
Federal and state officials are encouraging public-health professionals, doctors, and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms, and health Web sites. According to a report in The Wall Street Journal, nearly 9 out of 10 adults have difficulty following routine medical advice, often because it is incomprehensible to the average person. A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors' practices, and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases, and suggests plain-English replacements. Use of such products can help insured persons “better appreciate the importance of preventive services and recommended checkups,” according to Jo Poorman, senior director of print and digital media for Chicago-based Health Care Service Corp., a Blue Cross and Blue Shield provider.
Health IT products expected to push sales of handheld devices through 2015
Handheld device sales for healthcare use are expected to increase over the next 5 years as physicians and hospitals purchase new information technology systems, according to a report by New York City-based Kalorama Information. Already at $8.2 billion globally in 2009, handheld sales are expected to increase by 7% through 2015, according to “Handhelds in Healthcare: The World Market for PDAs, Tablet PCs, Handheld Monitors and Scanners.” Stimulus incentives are a big factor, as are a growing and aging population, a shortage of qualified medical professionals, cost restraints, and medical error reduction measures, according to the report. The propensity of doctors and nurses to use the devices is also driving sales, Kalorama Information Publisher Bruce Carlson said.
PharmaTrust to expand use of pharmaceutical ATMs in Canada
Oakville, Ontario–based PharmaTrust and the Ontario Telemedicine Network (OTN) are expanding use of its ATM-like pharmaceutical drug dispensers in hospitals throughout the Canadian province. According to Steve Gesner, chief information officer at PharmaTrust, the deal with OTN will allow the company to quickly deploy its MedCentres—often described as a “pharmacist in a box”—at a number of the province's 1,000 hospitals. The application links a trained pharmacist to the patient through a two-way audio-video line. A scanner allows the pharmacist to read a prescription, which is then filled using drugs stored in the machine. The units have been tested at three locations in Ontario for several months, and the company recently signed a deal to provide MedCentre machines in the United Kingdom. Gesner said discussions are continuing with roughly 30 health facilities, and up to one third are showing “strong interest” in adopting the new technology.
Use of GlowCap e-bottle cap leads to greater medicinal compliance among patients
A division of Partners HealthCare, the Center for Connected Health, recently presented the results of a study that looked at the effectiveness of the use of a wireless electronic bottle cap on compliance in blood-pressure patients. The result of the study, which focused on the impact of the GlowCap developed by Vitality (Boston, MA), determined that use of the e-bottle cap resulted in a 27% higher rate of patient medication compliance compared to patients that did not use the device. The GlowCap uses a wireless chip that has four different services: the device flashes a light or plays a ringtone as a personal reminder; the device has social-network support that sends weekly e-mail updates to a friend or family member; the device can order refills from the pharmacy; and the device sends the patient and the doctor a monthly printed report with incentives if they exceed compliance goals.
MyHealth Clinic to expand mall-based clinics linked via telemedicine
MyHealth Clinic, based in Manila, Philippines, has announced plans to expand in the next 5 years by building three to four new clinics per year. In 2011, they intend to have five mall-based clinics. The company opened its first MyHealth Clinic in January 2009 at Festival Supermall in Alabang. As part of the expansion plan, MyHealth will link their clinics via an Internet-based consultation and diagnostic service. Currently, MyHealth Clinic has more than 50 doctors in specialties such as cardiology, pulmonology, obstetrics and gynecology, as well as primary care. Services include multi-specialty consultations, laboratory and drug testing, diagnostic imaging, dental services, and ancillary procedures. MyHealth Clinic serves insurance companies, HMOs, and walk-in patients.
Satellite used in historic South Pole telemedicine emergency to retire
Even satellites retire. NASA's Tracking and Data Relay Satellite 1 (TDRS-1) is retiring. Initially launched in 1983, TDRS-1 was used from 1983 to 1998 to allow NASA to talk to other orbital satellites. From 1998 to 2009, TDRS-1 was reassigned to support the National Science Foundation (NSF) and its U.S. Antarctic Program partners. Although the satellite was involved in numerous groundbreaking communications around the globe, in 1999 it was fundamental in allowing South Pole personnel at the Amundsen-Scott Station to conduct telemedicine conferences; most notable during that period, doctors in the United States guided Dr. Jerri Nielsen in performing a self-biopsy and administering chemotherapy after she was diagnosed with breast cancer. In 2002, TDRS-1 was again used to help physicians assist with knee surgery on a meteorologist spending the winter in Antarctica. The satellite was moved 200 miles above its previous orbit and shut down, with future plans to retire it so it will not pose a risk to other geo spacecraft.
Harrisburg University launches grad-level program in health informatics
Harrisburg University of Science and Technology (PA) announced the launch of a 12-credit graduate-level specialization in health informatics. The program will focus on the technical and management issues of health informatics and healthcare IT. The program consists of four courses: Healthcare Systems, Health Informatics and Information Systems, eHealth and mHealth, and Social Technical and Organizational Issues in Healthcare Information Technology. The program will start with a three-credit course, Healthcare Systems, in the fall 2010 Semester. Graduate-level students in three programs are eligible for the program: Information Systems Engineering and Management (ISEM), Project Management (PMGT), and Learning Technologies (LTMS).
Computer neural network from UPIM creates virtual heart attacks for study
A team of bioengineers from the University of Pennsylvania Institute for Medicine and Engineering in Philadelphia has created a computer neural network that accurately predicts how blood platelets respond to complex conditions found during a heart attack or stroke. According to Scott L. Diamond, professor of chemical and biomolecular engineering and the director of the Penn Center for Molecular Discovery, the system makes it possible to predict how an individual's platelets would respond to thousands of virtual heart-attack scenarios. The model is capable of accurately predicting platelet responses from among 10 blood donors. “With this information we can identify patients at risk of thrombosis or improve upon current forms of anti-platelet therapies,” Diamond said.
Australians to receive universal healthcare ID numbers
Despite lingering concerns over privacy issues, Australians will soon receive 16-digit identification numbers that store a patient's name, address, and date of birth, to be used as healthcare identification numbers. This is a first step to providing electronic health records nationwide to Australians in the wake of the government's $401-million (USD) budget to introduce a national electronic health-record program, which is expected to begin mid 2012. Australian patients will be able to decide whether to opt-in for the e-health record, although they will receive an ID number regardless. Information expected to be available in the record includes medications, test results, and immunization history. The identification numbers will be distributed by the Healthcare Identifiers Service, operated by Medicare Australia.
Wi-Fi adoption rates in healthcare climb 60% since 2009
The adoption and use of Wi-Fi within healthcare has grown by more than 60% over the past year in both wireless local area network and Wi-Fi RTLS (Real-Time Locations Systems) deployments, and high double-digit growth is expected to continue for at least the next few years, according to a report by ABI Research. The report, “Wireless Healthcare and Fitness Market Data,” notes that other wireless technologies being adopted and deployed in healthcare, including cellular M2M and wearable wireless sensors, have also seen significant growth over the past 12 months. Wireless communications that continue to be adopted in healthcare applications range from Wi-Fi networks to wearable sensors that wirelessly transmit a patient's condition to monitoring applications. Wi-Fi adoption has “helped overcome initial concerns about complexity and reliability of wireless within healthcare,” ABI Research principal analyst Jonathan Collins said.
New FDA online database designed to find new uses for old drugs
The U.S. Food and Drug Administration's Office of Orphan Products Development (OOPD) has launched a new database based on the concept of repurposing—the finding of new ways to use products that have already been okayed by the FDA for some other use. According to OOPD Director Timothy Coté, products in the Rare Disease Repurposing Database have already shown potential to treat one or more of the diseases affecting 200,000 or fewer Americans. Testing these already-approved drugs as treatments for rare diseases has significant advantages. “For one, it's already been found safe by the FDA,” Coté said. “And running trials on an existing drug is much cheaper than trying to develop a totally new compound.” Thus far, however, only 350 such “orphan” drugs have been approved, while there are about 7,000 rare diseases in the United States.
New noncontact body sensor can detect heartbeat from a meter away
Scientists at the University of Sussex have developed a noncontact body sensor that can detect a heartbeat from up to 1 meter away—something that can transform the way a patient's health is monitored. According to Dr. Robert Prance, professor of sensor technology at the Sussex School of Engineering and Design, the Electric Potential Sensors (EPS) are the first electrical sensors that can detect precisely the electrical activity of the heart without direct resistive contact with the body. The EPS will offer medical and home health professionals “the opportunity to develop patient-friendly, self-administered systems to monitor their vital signs with the minimum impact on their mobility,” Prance said. The team is currently working with Newbury, UK–based in-home smart technology company PassivSystems to evaluate whether the sensors could be used to help elderly and frail people live independently in their homes by monitoring occupancy in a room and even when someone's heartbeat has changed.
New pacemaker implant may help curb overeating, control obesity
An implanted, pacemaker-like device may help control obesity, according to a pair of studies by St. Paul, MN–based EnteroMedics Inc. The studies indicated that the company's Maestro System, which sends intermittent electrical impulses to the vagus nerve—which tells the brain when the stomach is empty—blocks impulses that make people overeat, EnteroMedics chief executive officer Mark Knudson said. The device is also far less invasive than bariatric surgery, he added. One study using the second-generation device showed improved glucose and blood-pressure levels in the project's 28 obese and type-2 diabetes-afflicted participants. Weight loss was “clinically meaningful,” according to the study. A second study shows a link between daily device use and weight loss among U.S. participants. The product is approved in Europe, and the company plans to launch it in the United States at a future date.
“Cloud” computing gains popularity among healthcare's decision makers
Nearly one third of healthcare-sector decision makers said they are now using “cloud”-based information technology applications, and nearly three in four said they are planning to move more applications to the cloud system, according to a recent report by technology services firm Accenture. The findings show that healthcare is in line with other industries in adopting remote, Internet-driven information storage systems. As with the healthcare sector, 32% of decision makers in manufacturing now resort to cloud technology. Education (29%) and retail (35%) are also making strides, the report notes. According to Accenture senior research scientist and report co-author Dadong Wan, healthcare is moving to cloud technology due to cost advantages and flexibility that cloud computing offers healthcare organizations, especially as they implement plans to meet the federal government's $20 billion financial incentive programs for the “meaningful use” of IT.
At-home monitoring of pacemakers “at least as effective” as conventional follow-up
Remote monitoring of pacemaker recipients is at least as effective as conventional follow-up in terms of safety, reduces the frequency of follow-up visits, and could be associated with a lower incidence of atrial arrhythmias and stroke, according to a study by researchers in France. The Comparative Follow-up Schedule with Home Monitoring (COMPAS) study is the first to review home monitoring of pacemakers—something that Americans take for granted, according to lead researcher Prof. Philippe Mabo from the Centre Hospitalier Universitaire de Rennes in northwest France. Whereas the U.S. Food and Drug Administration recognizes home monitoring as “just another follow-up method,” no such regulations exist in France. The results of the COMPAS study “certainly won't dramatically alter standard practice, [but] they could have an impact on the application [of French] law in terms of the medicolegal and financial aspects,” Mabo said.
EMRs can help pediatricians improve follow-up care, avoid errors
Electronic medical records (EMRs), better follow-up care, and more collaboration with patients and their families would help pediatricians avoid errors in diagnosing illnesses, according to a study by researchers at Baylor College of Medicine and the Houston Veterans Affairs Health Services Research and Development Center of Excellence. In the study, pediatricians from Houston and Cincinnati were asked about the types of errors in diagnosis they thought occurred most often in practice; how frequently diagnostic errors and resultant patient harm, if any, occurred; how and why such errors in diagnosis occur; and what measures could reduce errors in diagnosis. According to Dr. Hardeep Singh, a lead author and assistant professor of medicine and health services research at the VA's Health Services Research Center and BCM, physicians believed that EMRs would lead to improved patient follow-up and better diagnosis, which might relate to better care coordination and information availability.
Philips Research expands exploration of wearable patient health sensors
Philips Research is exploring the benefits of wearable sensors that measure an increasing number of vital signs. According to Steve Klink, spokesperson for Philips Research in Eindhoven, The Netherlands, the work is part of an effort to define new consumer systems and services that can lower the cost and improve the quality of healthcare through at-home patient monitoring. Technology under way includes the MyHeart program, which uses a belt of sensors worn around the waist to measure heartbeat and send electric signals through the torso to detect fluid in the lungs; Handheld Cardiac Diagnostics, which takes and analyzes blood samples for heart conditions, then reports results back to care providers via a portable device; and Auto Alert, a patient fall-alert necklace with an accelerometer and other sensors that automatically call for help if the patient does not or cannot do so. Auto Alert has been on the market since March; MyHeart and Handheld Cardiac Diagnostics are expected on the market by 2013, Klink said.
European Union to invest $61.7 billion on health IT projects through 2013
The European Union has launched 27 e-health projects this year in compliance with its new EU Framework Programme 7. The framework, currently funded until 2013 at a cost of $61.7 billion (USD), will focus on information and communication technology projects for personal health systems and patient safety, and international cooperation on Virtual Physiological Human. The personal health systems include key technologies, such as biosensors and secure communications, which can be built into “smart clothes,” and implants that help patients and their doctors monitor and manage their health status. Patient-safety projects address developments around software tools to help health professionals obtain the greatest possible information whenever they make decisions that may impact on patient safety. The virtual physiological human is a network of bio-informatics, genomics, and neuro-informatics researchers to help create a new generation of e-health systems to assist them in disease prevention, diagnoses, and treatment.
Doctors use robotics to perform kidney transplant on obese patient
Surgeons at the University of Illinois at Chicago have performed the first successful robotic kidney transplant in a morbidly obese patient. According to Dr. Enrico Benedetti, head of surgery at UIC, the university surgical team used the da Vinci Robotic Surgical System to transplant the kidney, which functioned immediately after transplantation with no postoperative complications. Transplant centers typically avoid listing morbidly obese patients for kidney transplantation due to the increased risks associated with surgery, graft survival, and patient safety. But robotic surgery on these persons can be accomplished safely and allows minimally invasive access without the visual and technical limitations of laparoscopic surgery, said Dr. Pier Cristoforo Giulianotti, professor of surgery at UIC. Six other robotic kidney transplants have been performed to date, but none in obese patients.
Implanted electrode process can help treat pancreatic cancer
Researchers at the University of North Carolina in Chapel Hill have designed an implant that uses an electrical field to supply chemotherapy drugs to hard-to-reach pancreatic cancer tumors. According to Joseph DeSimone at UNC's DeSimone Lab in Chapel Hill, an electrode carrying a reservoir of the drugs is implanted directly into the pancreas. When a second electrode is pinned to the side of the body or implanted inside, an electric field can be generated, driving the drugs out of the reservoir and into the tumor. Tests on pancreatic tumors in mice showed promising results, and the team hopes to publish its findings in the coming months, DeSimone said.
Actress Jennifer Lopez's Maribel Foundation to provide telemedicine for kids
Singer and actress Jennifer Lopez and her sister, Lynda Lopez, have launched a telemedicine-based healthcare foundation aimed at providing global medical care to children. According to “J-Lo,” The Maribel Foundation in Los Angeles will remotely link up physicians and specialists with children who need care. Lopez told news commentator and television host Larry King that the Foundation became a personal goal after she and her sister each became pregnant. “Obviously, when you become a mom, your perspective and your whole kind of view on life change,” she said. “It is a very big dream, which is to bring the best, most advanced healthcare to every child in the world, on the planet.” The foundation is named after her husband's sister, who died of a brain tumor at the age of nine.
Ontario Telemedicine Network posts 91% user gain in 1 year
In just 4 years, the number of patients using the Ontario Telemedicine Network (OTN) has surpassed the 100,000 mark, the Canadian medical agency reported. According to OTN chief executive officer Dr. Ed Brown, the network has helped generate 102,781 patient consults in fiscal 2009–10, a 91% increase in 1 year. Available in every hospital and hundreds of other healthcare locations across the province, OTN is one of the largest and most comprehensive telemedicine networks in the world, Brown said. Reaching 100,000 consults is a “significant milestone” and is “proof positive that telemedicine is becoming a mainstream channel for healthcare delivery,” Brown added.
Few Americans use EMRs or contact doctors with e-mails, poll finds
Fewer than 1 in 10 U.S. adults now use electronic medical records or turn to e-mail to contact their doctor, and nearly half aren't aware if their doctors use such technology, according to a new poll by Harris Interactive. Most of those polled would like their doctors to have that type of access to their records, but not their health insurers, according to Harris Poll Chairperson Humphrey Taylor. The poll also notes that public attitudes toward electronic medical records haven't changed much over the past few years, despite efforts by President Obama to expand the use of EMR technology. This year, as in 2009, 78% of adults indicated that they “strongly” or “somewhat” agree that doctors should have access to their EMRs. In 2007, 80% were in agreement on physicians' access to those records, the poll notes.
Pharmaceutical firms to share Alzheimer's research in first-ever public database
In an effort to improve drug development for the treatment of Alzheimer's disease, a group of major pharmaceutical firms has agreed to share its research in a first-ever public database created by the Coalition Against Major Diseases (CAMD). Data from 4,000 patients across 11 failed Alzheimer's-drug clinical trials from Johnson & Johnson, GlaxoSmithKline PLC, AstraZeneca PLC, Sanofi-Aventis, and Abbott Laboratories became publicly available as of July, according to CAMD Executive Director Marc Cantillon. Data from additional drug makers and the National Institutes of Health will be added in the future. The data will be available to all participating drug makers, as well as qualified outside researchers. The detail and scope of this database will allow researchers to predict more accurately the course of Alzheimer's and other neuro-degenerative diseases, enabling the design of more efficient clinical trials, Cantillon said. The coalition plans to create similar pooled databases for Parkinson's disease and tuberculosis, Cantillon added. More information on the database is available at
Philips, NMT collaborate on home monitoring product for heart-failure patients
Royal Philips Electronics and Las Vegas–based Noninvasive Medical Technologies Inc. (NMT) are collaborating on a deal designed to expand home-monitoring capabilities for congestive heart failure (CHF) patients. According to Paul Bromberg, general manager of Philips Remote Patient Monitoring, Philips will market, sell, and distribute NMT's ZOE fluid status monitors with Philips' patient telemonitoring service. ZOE measures the accumulation of fluid in the chest, an early indicator of heart failure. Fluid status monitors supplement Philips' existing telemonitoring solution, which measures vital signs including weight, blood pressure, and blood oxygen saturation, as well as measurements from other third-party equipment such as blood-glucose monitors, Bromberg said. Roughly 5.7 million people in the United States suffer from CHF and require monitoring and management of fluid status, according to the American Heart Association.