Remote Cardiac Monitoring.

Remote Cardiac Monitoring.

Remote Cardiac Monitoring works by using a tele-medicine type system; this is really handy as the mechanism can be monitored from the patient’s home. The specialist team will be able to view information at any given time.

If for any reason there is any change in the device or in the condition of health in the patient then the specialist team can be alerted. This can be picked up much sooner than the standard way of monitoring the patient.

The specialist team would also be notified if there is any change with the patients symptoms, at that point a review or consultation or just the typical home visit would evaluate if intervention is really needed.

In the case of a clinical event of any detection the rate was reduced in 79%, a reduction of 66% with admissions for irregular heartbeat or an abnormal rhythm and symptoms linked to strokes. Also a 50% reduction with any associated chance of death.

This efficient monitoring device provides a higher standard of care and close observation which              is not only suitable for the patients but also more timely for the hospital team.

The clinical results are improved meaning early warning signs and intervention results in a higher survival rate.

Remote monitoring allows a more well organized management of this device in their clinic and keeps the standard at a level although the amount of patients using this device is still growing.

Follow ups

A follow up in the management in trial fibrillation has its advantage, and that is to detect a new reaction during the abnormal heart beat that has been occurring.

This highly developed device can give the cardiologist or physiologist enough information and the arrhythmia occurrence such as the time and date of any onset problems, the way the heart is beating during the arrhythmia. However this information can only be accessible when the patient arrives for a follow up which is normally every 6 or 12 months, which does hold back the process of the atrial fibrillation. This comes with huge restrictions, mainly to patients that have a warning and the patients that have un- noticeable symptoms.

Costs

At a cost of £95,264, the process of developing a remote service that monitors 1611 consultants that are face to face and 1074 downloads which are scheduled for remote monitoring. Remote follow-ups tariffs were priced just below £38 occurring a 70.4% complete reduction of cost.

A reduction of 40% was noted for follow ups, was matched when a consultant time was used to measure the standard face-to-face appointment which totalled 1343 hours compared to 806 hours.

How suitable is remote monitoring for all?

Some patients actually like coming to the clinic for a one- on -one, as this can make them feel more at ease.  Older patients tend to feel timid about the technology side of it. Many patients do not have access to phone lines, while a small number of patients feel that this system is just not for them.

 How to manage alerts

Ever the remote monitoring system has to be checked every day for alerts, if the clinic is short staffed this can be a problem. Obviously in the beginning there would only be a small number of alerts but as time goes on the alerts increases as the number of patients using this device grows.

Administration

Good administration is very important to have so they can access computer systems and help out by removing and transferring patients, making orders for the communicators, make appointments, help out by answering basic questions, pull patient records and files for devices and alerts and entering patients on the computer system.

Quality care of the patient is significantly improved because the patients in need of been assisted are taken care earlier due to improved monitoring.

This is very important due to the high risk of an unfortunate outcome, like strokes and heart problems. In the case of the device malfunctioning and alerts, earlier detection means the patient can receive treatment much sooner.

Patients that use this service and people such as carers and family recognizes a huge improvement, as less travel is involved which means less hospital visits, early detection of any oncoming symptom. The treatment is simplified as any problems are found much earlier. Many patients, mainly elderly patients will suffer less anxiety as well as any abnormalities or any defibrillator malfunctions. Instead of every 6 months all devices are constantly checked.

 Only a small number of patients will have problems that are detected remotely, like atrial fibrillation and normally this condition would have be found at one of the follow-up routine checks, therefore clinical intervention would not really be increased.

If a patient develop symptoms an earlier detection together with sooner intervention, then this could possibility reduce costs of healthcare, such as preventing strokes.

Any time deterioration is detected, like the onset of heart failure becoming worse, at this time an outpatient appointment will more than likely be needed.

However the patient life will have improved and have quality due to intervention ,detecting problems sooner and overall less hospital visits or hospital stays, even less communication with the GP.

This proves that managing the disease by device monitoring works and extending the use of technology is needed.

Overall face- to- face appointments will subsequently reduce and healthcare cost will fall.

Remote care for patients with heart problems can easily take place of community care and GPs.

About 80% of patients will not experience any need for reprogramming. More time can be given to patients with a higher demand for attention. Fewer visits to the hospital with those who do visit have a quick discharge. All this will help reduce travel for the physiologist staff within different hospitals and trusts.

As we know patients that are in a high risk bracket can benefit from detecting their symptoms early. However it is still unclear whether this remote device would be given to all patients or just the ones that will most likely benefit from this technological device.