Mobile health and implantable cardiac devices: Patients' expectations

Background Mobile computing and communication technologies in health services and information (so-called mHealth) have modified the traditional approach in the follow-up of patients with implantable cardiac devices, increased patient engagement and empowerment, reduced healthcare costs and improved patients' outcome. Recent developments in mobile technology, with the introduction of smartphone-compatible devices that can measure various health parameters and transfer automatically generated data, have increased the potential application of remote monitoring and the interest towards mHealth. However, little is known about the patients' interest and expectations of this new technology. Objective The patients' interest in the possibility of receiving data from their implantable cardiac device, clinical and health advice via remote monitoring on their smartphones were investigated. Methods A questionnaire entitled ‘Expectations for future possibility of self-management of device data’ (Likert scale scored) was submitted to 300 consecutive implantable cardiac device outpatients. The questionnaire was focused on collecting patients’ expectations in receiving direct information regarding their implantable cardiac device status (item 1, five questions), their own clinical status (item 2, seven questions) and advice on healthy lifestyle promotion (item 3, nine questions). Patient characteristics associated with greater interest towards mHealth were also investigated. Results Questionnaires were completed by 268 patients (221 men, aged 69 ± 14 years). The Cronbach test reported an alpha value of 0.98 for item 1, 0.94 for item 2 and 0.97 for item 3. Patients declared to be mainly interested in the device interventions (62%) and in severe arrhythmia occurrence (61%), followed by data on heart failure severity (54%) and their performed physical activity (48%). Patients showed very little interest in ECG tracing (37%), but the lowest interest was expressed towards healthy lifestyle promotion advice (<40%). A higher education degree and the presence of the caregiver positively affected the interest towards remote monitoring information ( P < 0.001). Conclusions The patients' interests were mainly directed at receiving information related to technical data of the implantable cardiac device and not to the overall management of the disease, underlying the insufficient awareness of patients towards the key role of self-control health status and the promotion of a healthy lifestyle.

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Automatic Remote Monitoring of Implantable Cardiac Devices in Clinical Practice – The Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) Trial

European Cardiology Review ◽

10.15420/ecr.2010.6.3.87 ◽

2010 ◽

Vol 6 (3) ◽

pp. 87

Author(s):

Niraj Varma ◽

Keyword(s):

Clinical Practice ◽

Remote Monitoring ◽

Home Monitoring ◽

Implantable Devices ◽

Cardiac Device ◽

Cardiac Devices ◽

Enhance Patient Safety ◽

Implantable Cardiac Devices ◽

Post Implantation

The use of implantable electronic cardiac devices is increasing. Post-implantation follow-up is important for monitoring both device function and patient condition; however, clinical practice is inconsistent. For example, implantable cardioverter–defibrillator follow-up schedules vary from every three months to yearly according to facility and physician preference and the availability of resources. Importantly, no surveillance occurs between follow-up visits. By contrast, implantable devices with automatic remote monitoring capability provide a means for performing constant surveillance, with the ability to identify salient problems rapidly. The Lumos-T Reduces Routine Office Device Follow-up Study (TRUST) demonstrated that remote home monitoring reduced clinic burden and allowed early detection of patient and/or system problems, enabling efficient monitoring and an opportunity to enhance patient safety. The results of the trial have significant implications for the management of patients receiving all forms of implantable electronic cardiac device.

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Clinical Medicine: Advances in Implantable Cardiac Devices

Canadian Journal of General Internal Medicine ◽

10.22374/cjgim.v9i3.37 ◽

1970 ◽

Vol 9 (3) ◽

Author(s):

Jorge Palazollo MD ◽

Sheldon M. Singh MD

Keyword(s):

Clinical Medicine ◽

Cardiac Pacing ◽

Implantable Cardioverter Defibrillators ◽

Cardiac Device ◽

Cardiac Devices ◽

Slow Pulse ◽

Implantable Cardiac Device ◽

Implantable Cardiac Devices ◽

Future Technologies ◽

Cardioverter Defibrillators

The use of implantable cardiac devices has increased and will continue to increase as the population ages. For more than 50 years, patients with a slow pulse have enjoyed the benefits of cardiac pacing to alleviate symptoms and, in some cases, prolong life. Implantable cardiac devices have evolved; in addition to providing pacing support, some devices – namely, implantable cardioverter defibrillators (ICDs) – can also terminate malignant ventricular arrhythmias, facilitate the synchronization of ventricular function, monitor clinical variables, and store a wealth of information to assist clinical management. This review discusses currently available device diagnostics, highlights some advances in implantable cardiac device therapy, and provides a preview of future technologies that may improve the care of patients who have these devices.

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Transmission Rates of Implantable Cardiac Device Patients who are Followed up with Remote Monitoring

Heart Lung and Circulation ◽

10.1016/j.hlc.2016.06.373 ◽

2016 ◽

Vol 25 ◽

pp. S158

Author(s):

D. Wright ◽

M. Parfitt ◽

J. Betts ◽

A. Lee ◽

R. Denman

Keyword(s):

Remote Monitoring ◽

Cardiac Device ◽

Transmission Rates ◽

Implantable Cardiac Device

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Remote monitoring versus conventional follow-up for implantable cardiac devices: Rationale and design of the PORTLink (PORTuguese Research on Telemonitoring with CareLink) trial

Revista Portuguesa de Cardiologia (English Edition) ◽

10.1016/j.repce.2013.06.019 ◽

2013 ◽

Vol 32 (12) ◽

pp. 957-964

Author(s):

Mário Oliveira ◽

Milene Fernandes ◽

João Primo ◽

Hipólito Reis ◽

Paulo Nicola

Keyword(s):

Remote Monitoring ◽

Cardiac Devices ◽

Implantable Cardiac Devices

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Abstract 287: Vendor-neutral Clinic Management Software Use Is Associated With Time Savings For Remote Monitoring

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.287 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Eliana Biundo ◽

David Lanctin ◽

Sarah C Rosemas ◽

Emmanuelle Nicolle ◽

Alan Burke

Keyword(s):

Remote Monitoring ◽

Full Time ◽

Staff Time ◽

Cardiac Device ◽

Review Time ◽

Management Software ◽

Clinic Management ◽

Remote Transmission ◽

Cardiac Devices ◽

Time Savings

Background: As cardiac implantable electronic devices (CIEDs) have increased in complexity and sophistication, a transition from in-person follow-up to remote device management has taken place. The amount of information collected via cardiac devices has also increased, making the development of efficient workflows necessary for operational sustainability. Vendor-neutral clinic management software organizes patient, device, and programmer information, and thus has potential to improve remote monitoring workflow and data management. This study sought to examine whether management software use is associated with reduced time to review manage remote transmissions. Methods: A time and motion workflow analysis was performed in 6 U.S. cardiac device clinics, 3 of which use management software (Medtronic Paceart Optima™). Participating sites had an average size of 4,217 (range of 870 to 10,336) CIED patients managed. Each step involved in remote transmission review (including all clinical and administrative tasks, such as chart documentation and billing) was repeatedly timed, for all device models/manufacturers, during one business week (5 days) of observation at each clinic. The time to review an average remote transmission was calculated based on the mean time to perform each step as well as published literature, and stratified by sites with or without management software. Annual staff time required for remote monitoring was modeled by multiplying the average remote transmission review time by the average number of annual transmissions per patient across the 6 sites: 16.1 transmissions/year, representing a weighted average of therapeutic cardiac devices (4.2 transmissions/year) and insertable cardiac monitors (38.9 transmissions/year). Results: A total of 1,290 remote transmission review activities (725 with management software; 565 without management software) were observed and measured during 6 weeks of data collection. On average, the total staff time to review a remote transmission was 2.1 minutes lower at sites with management software (13.6 vs. 11.5 minutes). Extrapolated to the average clinic size of 4,217 patients, this translates into a potential annual time savings of 2,329 hours for sites with management software (13,026 vs. 15,355 hours of total transmission review time). This represents collective time savings across all clinical and administrative staff, and equates to 1.24 annual full-time equivalents (6.9 vs. 8.2 full-time equivalents). Conclusion: Remote monitoring of CIED patients requires significant staff time in cardiac device clinics. Management software is an effective tool in optimizing management of remotely monitored patients, and these benefits may translate into time savings for cardiac device clinics.

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