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Real-world Evaluation of the Impact of Remote Patient Management in Heart Failure on Care Consumption and Care Time
ABSTRACT
Background:
Remote Patient Management (RPM) is a strategy to track daily health data in patients with heart failure (HF) to enable early detection and treatment of decompensation to prevent hospital readmissions. Implementation of RPM alters standard care and redistributes provider responsibilities. Although randomized controlled trials demonstrate positive clinical outcomes, the impact of implementing remote patient monitoring on patients’ healthcare utilization, as well as the care time and workload of healthcare providers in a real-world setting, remains unclear.
Objective:
The goal of this retrospective study is to evaluate the effects of implementing remote patient monitoring for heart failure on patient care consumption and caregiver workload within a regional care network.
Methods:
Two hospitals in the same regional care network with aligned care pathways for usual care were compared: one with remote patient monitoring (Hospital 1) and one without (Hospital 2). Between June 2021 and July 2022, HF patients were included from a clinical registry with one-year follow-up. Cardiac healthcare consumption was quantified by the number and duration of consultations (in-person, phone, RPM) with HF-nurses and cardiologists. HF-related readmissions were also collected. Three groups were analyzed: Hospital 1 Usual Care (UC)+RPM, Hospital 1 UC, and Hospital 2 UC.
Results:
131 patients were included (Hospital 1 UC+RPM: 34, Hospital 1 UC: 64, Hospital 2 UC: 33). Consultation frequency and duration were significantly higher in the UC+RPM group (p < 0.001), mainly due to increased HF-nurse consultations (p < 0.001). No significant differences were observed regarding cardiologist care time, cardiologist number of consultations or HF-related readmissions.
Conclusions:
In this real-world study, implementation of RPM in patients with HF increased nurses' workload without benefit on cardiologists’ consultations or patient outcomes. These findings highlight the need for optimization at organizational and technological levels and underline the importance of real-world evaluation of implementations of innovations.
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Copyright
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