JMIR Publications

ABSTRACT

Background:

Remote patient monitoring (RPM) using non-invasive clinical data and structured telephone calls in the heart failure (HF) population in order to prevent heart failure hospitalizations has been studied in multiple randomized controlled trials with mixed results.

Objective:

Using a novel digital health care platform designed specifically to proactively manage HF patients and the multiple factors that lead to HF re-exacerbation and readmission, we hypothesize that active patient management with this RPM system, when integrated into standard cardiology care, enables improved patient care and reduces ER visits and HFH.

Methods:

This is a retrospective review of New York Heart Association (NYHA) Class II and III HF patients who were followed over a 4-year period at a single institution, 2 years prior-to and 2 years post-initiation of a novel system to assess the impact of RPM on HF management.

Results:

Forty patients with at least 4 years of follow-up, 2 years prior to RPM initiation and 2 years post-RPM initiation, were included. In the 2 years that followed RPM initiation, check-up calls increased 500%, medication change calls increased 470%, and total calls increased by 482%. Emergency room visits for HF fell 93%, heart failure hospitalizations fell 83%, and all other cardiovascular hospitalizations fell 50%. Additionally, the total number of office visits declined by 15% post RPM, and unscheduled/urgent office visits declined by 73%.

Conclusions:

Daily monitoring of trended vital sign data between engaged patients and clinicians, when incorporated into daily clinical workflow, allows for immediate response and intervention to the precursors of HF decompensation resulting in increased contact between patients and their clinicians and a reduction across all HF admission types over 2 years of follow-up.