MED360 RPM

• Continuous monitoring of patients with chronic conditions from home
• Intelligent 3-level alert engine that routes the right message to the right person
• Clinician-configurable thresholds per patient and per care pathway
• Real-time secure video consultations between patient and care team
• Full audit trail compliant with Canadian privacy legislation (PIPEDA / provincial health acts)
• Interoperable architecture ready for integration with provincial EMRs and wearable APIs

1. Patient submits reading via mobile app or device Bluetooth sync
2. API Gateway validates JWT token and request schema
3. Reading stored in PostgreSQL with patient ID, timestamp, and device type
4. Alert Engine compares reading against patient-specific thresholds
5. If threshold exceeded, Alert Engine classifies Level 1, 2, or 3
6. Notification Service enqueues SMS job(s) in Redis queue
7. Queue worker sends SMS via Twilio/Vonage within 30 seconds
8. Dashboard flag updated in real time via WebSocket push
9. Full audit log entry created for every action taken

The following reported symptoms trigger a Level 3 Emergency Alert immediately, regardless of vital sign values:

1. Patient enrolled by clinic admin — receives onboarding SMS/email
2. Patient downloads mobile app and completes profile setup
3. Patient connects home devices via Bluetooth or manual entry
4. Each morning patient submits daily readings (BP, weight, SpO2, HR)
5. Patient answers daily symptom check-in (5 questions, under 2 minutes)
6. Alert Engine evaluates readings against personal thresholds
7. Patient receives SMS feedback: all-clear, guidance, or emergency instruction
8. If Level 2+, patient notified that care team has been alerted
9. If nurse/doctor initiates video call, patient receives push notification and SMS
10. Patient joins video call — clinician reviews readings live and adds notes

1. Clinician logs in to web dashboard
2. Dashboard shows prioritised patient list: RED > ORANGE > YELLOW > GREEN
3. Clinician selects a flagged patient to view full reading history and trend charts
4. Clinician acknowledges alert — logs timestamp and name
5. Clinician can send message, initiate video call, or adjust thresholds
6. Video call window opens — patient vitals panel visible alongside video
7. Post-call notes saved to patient record with timestamp
8. If escalation needed, clinician triggers Level 3 manually from dashboard

1. Clinician clicks “Video Call” button on patient card in dashboard
2. System checks patient availability status (online/offline in app)
3. WebRTC/Agora session initiated — unique encrypted room ID generated
4. Patient receives in-app push notification and SMS with join link
5. Patient clicks link or notification to join from mobile app
6. Video session begins — clinician sees patient vitals panel alongside video
7. Session is end-to-end encrypted per PIPEDA requirements
8. Clinician can capture screenshots of abnormal readings during call (with consent)
9. On call end, clinician adds structured notes (reason, assessment, plan, follow-up date)
10. Call record saved: duration, timestamp, participants, notes, recording consent status
11. Patient receives post-call summary via in-app message

• PIPEDA (Personal Information Protection and Electronic Documents Act) — federal baseline
• PHIPA (Ontario) / HIA (Alberta) / PIPA (BC) — provincial health privacy acts
• Data residency: all patient data stored in Canadian AWS/Azure regions
• Explicit informed consent captured at onboarding with full audit record
• Right to access, correct, and delete personal health information built in

• Default thresholds set by clinical advisory board at platform level
• Clinic medical directors can override defaults for their organisation
• Individual doctors can set patient-specific thresholds — changes logged with rationale
• Threshold change history preserved and cannot be retroactively altered
• Pathway templates: Heart Failure, COPD, Hypertension, Diabetes — pre-configured and peer-reviewed
• System will not allow thresholds outside physiologically plausible ranges

• Canadian digital health market projected at $3.8 billion CAD by 2027
• RPM reimbursement pathways established or emerging in ON, BC, AB, QC
• Average cost saving: $2,400 CAD per avoided hospital readmission
• Target: 100 clinics, 50,000 patients in Year 3

• Canada Health Infoway — Digital Health Solutions fund
• CIHR — Health System Impact Fellowships & Digital Health grants
• NRC IRAP — Industrial Research Assistance Program for health tech SMEs
• OTF (Ontario Trillium Foundation) — Community health technology grants
• SDTC — Sustainable Development Technology Canada
• MaRS Health — Toronto-based digital health accelerator program

1. Phase 1: Pilot with 2 clinics, 200 patients — 6 months
2. Phase 2: Efficacy study measuring readmission reduction — 12 months
3. Phase 3: Multi-province rollout with provincial health authority partnership
4. Phase 4: COTS submission and national scale with Infoway partnership