Relying on Patients for Good Remote Device Data

If updated regularly, remote monitoring informs physicians within hours of a health event

New technologies are making healthcare more efficient all the time. Today, remote monitoring of implanted heart devices is a growing technology.

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“We are now moving to a paradigm of continuous remote monitoring, with events being flagged for the physician’s attention within hours of happening,” explains Edmond Cronin, MD, Electrophysiology Resident, Department of Cardiovascular Medicine. 

This means that unnecessary doctor visits can be reduced. Heart patients need only come in when there is a health issue such as an arrhythmia—or a device issue, such as the need for a battery change. Previously, patients with pacemakers and implantable cardiac defibrillators (ICDs) came into clinic every three to six months for device checks. This meant health events occurring in these intervening months went unchecked. And for others, it meant that doctor visits did not turn up any new or actionable health information.

But as with any new technology, it is only as good as the input of information. Dr. Cronin joined colleagues in a study of remote monitoring on device clinic workflow with results recently published in the journal Heart Rhythm.

“Remote monitoring has been rolled out extensively, however data on how it affects our workflow have been lacking, until now,” says Dr. Cronin. “In our research we learned that a surprising number of patients failed to transmit as scheduled.”

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heart-stethoscope

While some patients missed their scheduled input times, he explained, a number of patients transmitted the information twice “just to be sure” it was submitted. This means double the work for the device clinic, and may be due to unfamiliarity or a lack of trust in the technology. Basically, poor compliance complicates the efficiency of workflow.

This is more likely to happen with systems requiring the patient to send a transmission manually. Some newer systems are automatically sending transmissions without the patient having to do anything.

Dr. Cronin notes that moving towards continuous, automatic remote monitoring will help. He would also like to see an increase in the programmability of the remote monitoring systems to allow physicians to tailor the transmissions to a doctor’s individual workflow requirements.

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In the meantime, doctors are working with patients to ask for their help in proper input of information. It provides an advantage for patients and doctors alike.

Source: Cronin, E.M., Ching, E.A., Varma, N., Martin, Wilkoff, B.L., Lindsay, B.D.,
Remote monitoring of cardiovascular devices – a time and activity analysis, Heart Rhythm (2012), doi: 10.1016/j.hrthm.2012.08.002

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