scholarly journals Haemodynamic Monitoring Devices in Heart Failure: Maximising Benefit with Digitally Enabled Patient Centric Care

2018 ◽  
Vol 7 (4) ◽  
pp. 1 ◽  
Author(s):  
Leah M Raj ◽  
Leslie A Saxon ◽  
◽  

ICDs and resynchronisation devices are routinely implanted in patients with heart failure for primary prevention of sudden cardiac death or to treat the condition. The addition of device features and algorithms that directly or indirectly monitor cardiac haemodynamics to assess heart failure status can provide additional benefit by treating heart failure more continuously. Established and emerging devices and sensors aimed at treating or measuring cardiac haemodynamics represent the next era of heart failure disease management. Digitally enabled models of heart failure care, based on frequent haemodynamic measurements, will increasingly involve patients in their own disease management. Software tools and services tailored to provide patients with personalised information to guide diet, activity, medications and haemodynamic management offer an unprecedented opportunity to improve patient outcomes. This will enable physicians to care for larger populations because management will be exception based, automated and no longer depend on one-to-one patient and physician interactions.

2019 ◽  
Vol 35 (S1) ◽  
pp. 72-72
Author(s):  
Susan Myles ◽  
Ruth Louise Poole ◽  
Karen Facey

IntroductionEvidence supporting the use of pacemakers is well established. However, evidence about the optimal use of pacemaker telemonitoring for disease management in heart failure is not. Health Technology Wales (HTW) held a national adoption event to encourage implementation and best practice in use of pacemaker telemonitoring in the National Health Service (NHS) Wales to improve patient outcomes in heart failure.MethodsMulti-stakeholder national adoption workshop using a mixture of expert presentations, case studies and interdisciplinary group and panel discussions to agree key actions to understand the value and promote optimal use of pacemakers for remote disease monitoring in patients with heart failure in Wales.ResultsThe workshop was attended by forty-five senior professionals with an interest in improving care of patients with heart failure. Actions to progress included: providing a centralized Welsh system to support technical issues that arise with telemonitoring; considering interoperability with other NHS Wales systems; encouraging value-based procurement with collection of a core outcome set; agreeing implementation issues with both professionals and patients; audit to understand experience, resource use and outcomes; and sharing manufacturer evidence on the accuracy of telemanagement algorithms. It was suggested that these actions be progressed via an All-Wales multi-stakeholder approach, led by the Welsh Cardiac Network.ConclusionsDeveloping a more agile, lifecycle approach to technology appraisal is currently advocated; recalibrating the focus from technology assessment to technology management across the complete technology lifecycle. HTW will endeavour through regular adoption events to facilitate such a paradigm shift that aims to understand value and optimise use of evidence-based technologies.


2020 ◽  
Vol 15 (9) ◽  
pp. 1-9
Author(s):  
Marianne O'Hara ◽  
Amanda Smith ◽  
Emma Foster ◽  
Stephen J Leslie

Introduction: This project aimed to assess and optimise the treatment of all patients with heart failure with reduced ejection fraction (HFrEF). Methods: Consecutive patients discharged with a heart failure code (ICD-10) between April 2014 and July 2017 were included. The medical records were reviewed to ensure optimal medical therapy and in cases where this was not being received, a process of ‘active optimisation’ was initiated. Results: Out of 656 patients, 139 were identified as eligible for guideline-directed treatment, 129 (93%) of which were receiving optimal medical therapy. Of these, 47 (36%) were deemed to be optimised but were not on full guideline-directed therapy owing to contraindication, intolerance, comorbidities or non-compliance. Conclusion: The project data reflect real-world patients and practice and highlight a tension between guideline-based care and real-life (realistic) medicine.


2000 ◽  
Vol 6 (4) ◽  
pp. 290-299 ◽  
Author(s):  
Barbara Riegel ◽  
Beverly Carlson ◽  
Dale Glaser ◽  
Peter Hoagland

2005 ◽  
Vol 11 (5) ◽  
pp. 358-365 ◽  
Author(s):  
Wm. Claiborne Dunagan ◽  
Benjamin Littenberg ◽  
Gregory A. Ewald ◽  
Catherine A. Jones ◽  
Valerie Beckham Emery ◽  
...  

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