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Manpower and Outpatient Clinic Workload for Remote Monitoring of Patients with Cardiac Implantable Electronic Devices: Data from the HomeGuide Registry
- Source :
- Journal of Cardiovascular Electrophysiology. 25:1216-1223
- Publication Year :
- 2014
- Publisher :
- Wiley, 2014.
-
Abstract
- Manpower of Cardiac Device Home MonitoringBackground This study aimed to assess manpower and resource consumption of the HomeGuide workflow model for remote monitoring (Biotronik Home Monitoring [HM], Biotronik SE & Co. KG, Berlin, Germany) of cardiac implantable electronic devices in daily clinical practice. Methods The model established a cooperative interaction between a reference nurse (RN) for ordinary management, and a responsible physician (RP) for medical decisions in each outpatient clinic. RN reviewed remote transmissions and alerts, addressing critical cases to the RP. Results A total of 1,650 patients were enrolled in 75 sites: 25% pacemakers (PM), 22% dual-, 27% single-chamber implantable defibrillators (ICD), 2% PM with cardiac resynchronization therapy (CRT), and 24% ICD-CRT. During a median follow-up of 18 (10–31) months, 3,364 HM sessions were performed (74% by the RN, 26% by the RP) to complete 18,478 remote follow-ups. Median duration of remote follow-ups was 1.2 (0.6–2.0) minutes, corresponding to a manpower of 43.3 (4.2–94.8) minutes/month every 100 patients for nurses and 10.2 (0.1–31.1) for physicians (P < 0.0001). RN submitted 15% of remote transmissions to RP, who decided unscheduled follow-ups in 12% of the cases. The median manpower for phone calls was 1.9 (0.8–16.5) minutes/month every 100 contacted patients. There were 2.84 in-hospital visits/patient, 0.46 of which triggered by HM findings. A cumulative per-patient HM follow-up time of 15.4 minutes (20% of total follow-up time) allowed remote detection of 73% of actionable events. Conclusions HM implemented in the HomeGuide workflow model required
- Subjects :
- Remote detection
Telemedicine
business.industry
medicine.medical_treatment
Cardiac resynchronization therapy
Workload
medicine.disease
Implantable defibrillators
Physiology (medical)
Outpatient clinic
Medicine
Medical emergency
Resource consumption
Cardiology and Cardiovascular Medicine
business
Cooperative interaction
Subjects
Details
- ISSN :
- 10453873
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Electrophysiology
- Accession number :
- edsair.doi...........7d1a0cbf3d2080af70ee1ba31ad89f58