Remote Management of Chronic Cardiac Diseases in a Multicentre Hospital Network
About this good practice
WHY?
Telemonitoring in CARDIOLOGY helps reducing complications, hospital admissions and patient mortality.
FOR WHOM?
All patients implanted with an electronic cardiac device and/or with heart failure
AREA: Nouvelle-Aquitaine region
WHAT IS IT FOR?
1/ REMOTE MONITORING (RM) of CARDIAC IMPLANTABLE ELECTRONIC DEVICES: daily transmissions of technical and clinical data via a remote transmitter to the patient's home >enables near real-time detection of device failure or clinical complications
2/ REMOTE MANAGEMENT OF HEART FAILURE: daily transmissions of vital data and patient symptoms using connected wearables and an app. Integration of the results of biological check-ups and data from implanted cardiac devices on the same platform. >a COMPREHENSIVE APPROACH
>over a 15-month period involving 161 older patients, there were 106 worsening heart failure events and 63% of these were managed via remote home management (Ploux et al., 2023)
3/ The telemonitoring centre is piloting a REMOTE MONITORING NETWORK that includes 14 other centres in the region.
Obj:
>Offering a RM/management strategy to the largest number of patients
>Promoting remote management of chronic diseases
>Improving interprofessional collaboration and professional practice
>Creating big-databases for research purposes
Bordeaux University Hospital is using a RM system: CareLine Solutions, based on CONNECTED WEARABLES >combines information from prostheses with vital parameters collected at home + chronic pathologies
Resources needed
FINANCIAL
Reimbursed by the national health insurance
HUMAN
>Bordeaux University Hospital:
7 professionals dedicated to telemonitoring (8am to 5pm 5/7 days):
•1 cardiologist
•6 technicians of RM / administrative staff
>Peripheral centre (min requirements):
•1 cardiologist
•1 nurse RM
•Admin staff
Evidence of success
>PIONNEER in France in cardiology RM + creation of the 1st and unique UNIVERSITY DEGREE for RM technicians in France
>8,600 PATIENTS are monitored on a daily basis (2023) >largest RM centre in France. Half= older people (+65)
>+120,000 TRANSMISSIONS/year are managed
>2/3 of worsening episodes of heart failure are managed REMOTELY AT HOME
>Reduce mortality and hospital admissions
>AVAILABLE TO EVERY PATIENT (regardless of age, location), equal access to healthcare
>Improves INTERPRO collaboration
Potential for learning or transfer
This project could be transferred to other regions thanks to several success factors:
>This practice has been in place SINCE 2012 and has EXPANDED beyond the Bordeaux University Hospital with the creation of a REMOTE MONITORING NETWORK that includes 14 centres in the Nouvelle-Aquitaine region that trust the Hospital to monitor their patients remotely.
>The ORGANISATIONAL MODEL enables professionals to work together.
>The creation of LARGE DATABASES for RESEARCH PURPOSES is an important aspect of the project. These data could be used for studies and research in other European regions.
>The hospital has figures to support the EFFECTIVENESS of the practice, and their patient numbers are also constantly growing.
>The multicentre enables an effective strategy for overcoming the Human Resource obstacle and an effective medium to ensure EQUAL ACCESS to healthcare.
>The Bordeaux University Hospital aims to develop their heart failure network and COLLABORATE with new centres.
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