Vital data management platforms for cardiac device monitoring
The benefits of telemonitoring have been demonstrated in several clinical studies over the past two decades, including ON TIME. The data is very clear: The use of remote monitoring resulted in a 50% relative risk reduction in mortality compared to the standard of care for patients with heart failure.1 In addition, data recorded from these devices indicated more frequent early detection, resulting in faster interventions.1
Almost all of today’s implantable heart monitors, implantable cardioverting defibrillators, pacemakers, and external portable devices are designed with some sort of remote monitoring functions that can collect and transmit a large amount of data often used to determine a diagnosis or actively monitor the patient’s health. And given the possibility that remote monitoring potentially opens the door to better quality care that could allow patients to live longer and healthier lives, physicians have tended to steadily increase the number of remotely monitored patients as they arise. ‘they would supervise.
The widespread use of remote monitoring to manage patients with cardiac devices among general cardiologists and electrophysiologists was still in its infancy until about two years ago, when the pandemic began. forced the hands of hospitals, clinics and doctors across the country to not just be creative. ways to continue serving patients to high standards, but also to implement and embrace what were previously very specific forms of technology like rules and not exceptions. This has never been more evident than with the sudden increase in remote heart monitoring capabilities being implemented in healthcare facilities across the United States.
But the rapid adoption and the need for remote monitoring clinics during the pandemic has come, unsurprisingly, with steep learning curves and occasional setbacks, as the day-to-day management of cardiac device data has suddenly gone from a few steps away. hundreds of patients to sometimes thousands of patients in a very short period of time, negatively impacting the quality of care and offsetting the advantages of remote monitoring.
Institutions, hospitals and heart clinics are quickly learning that managing this amount of data can pose significant and ongoing challenges, both to their own teams and to their patients.
About two years before the pandemic, my team and I decided – in the best interests of our more than 4,000 heart device patients – that we would switch them all entirely to remote monitoring. Despite the aforementioned clinical benefits, which were the primary driver of our decision, the administrative burdens associated with handling the immense amount of patient data were straightforward and immediate. This affected virtually every aspect of our work, especially the time we could devote directly to treating our patients and their conditions.
The math didn’t work in our favor at all: over 4,000 patients requiring an office visit and device check every 90 days meant over 360,000 exams with 6-10 pages of data and data. heart alerts. On average, I and the other two physicians in our practice each spent five hours per week reviewing and approving these device reports, which was nothing compared to the hours our care teams spent managing administrative tasks. important preceding and following. our data reviews. The whole process, when done from start to finish, looks like this:
- Contact the specific device company representative to access all device queries, including actionable or emerging alerts
- Download heart data from the device company’s secure server
- Print data
- Read and review data
- Disconnect from data
- Initiate immediate actions or follow-up appointments based on the data
- Scan the data in EMR
- Bill Accurately for Medicare and Medicaid Time
In addition, we were constantly browsing four different vendor-specific software platforms, Abbott, BIOTRONIK, Boston Scientific and Medtronic, and occasionally a fifth, iRhythm. This gradually led to exhaustion as every facet of our record keeping for heart patients and their devices became increasingly tedious and hampered our ability to provide the best possible care. It was also wreaking havoc on our team and their daily workflow.
As countless other clinics are currently doing, we weighed several traditional options to manage the sudden change brought about by the complete shift to remote monitoring: hire additional members for our care and administrative teams, limit the acceptance of new ones. patients, or even use devices from just one or two manufacturers. But neither of these solutions was viable if we wanted to maintain differentiated and quality patient care at all levels.
A single healthcare IT software became the answer: a digital solution capable of hosting a robust data management platform that was scalable and configurable and created greater workflow efficiency while providing a variety of features. integrated and automated.
We absolutely needed three main processes:
- Consolidation of all cardiac data from each device manufacturer on a user-friendly digital dashboard
- Digital assessment and organization of all data and device queries in real time
- Full compatibility with existing EPM, EMR and billing programs
And to make sure each of those boxes was checked and met our specific quality standards, our practice took an unconventional approach: we created our own software.
In 2019, we tested our platform’s infrastructure and data management capabilities with our population of over 4,000 patients using devices. During this year, we have increased our billing skills by almost 50% and reduced the direct remote monitoring workloads for our administrative and care teams, on average, by almost 90%. It has become an immediate tool to promote the sustainability of our clinic.
And now, with remote monitoring clinics emerging out of necessity in rural and urban areas across the country in the wake of the pandemic, the key to the success of these clinics and the continued well-being of their patients is going to be integration of a device data management platform designed specifically to meet their needs.
Ideally, remote monitoring data management software should streamline data and alerts from multiple manufacturers onto a unified dashboard so that healthcare teams can continuously monitor the status of patient devices from within any mobile device, evaluate activity logs and add care notes without having to switch between manufacturer databases and different user interfaces. The software should also allow teams to view alerts related to all standard device transmissions, patient device recalls, successful or failed EMR downloads, and exam and billing status. of all remote reports.
The importance of scalability, configurability, and software workflow efficiency cannot be understated here. These three key features alone provide clinicians and healthcare teams with the ability to implement digital management platforms that precisely scale to their practice size and patient population, and they even empower teams researchers and academics embarking on clinical studies of new opportunities to collect and assemble cardiac devices. data more easily and efficiently.
Just a few years ago, data management software was slowly emerging as an exciting future possibility for physicians adopting remote monitoring, but the reality is that it has quickly become one of the most critical components in which every remote heart monitoring clinic in the United States should invest now.
- Hindricks G, et al; IN-TIME * study group. Multiparametric implant remote monitoring of patients with heart failure (IN-TIME): a randomized controlled trial. Lancet. 2014 Aug 16; 384 (9943): 583-590. doi: 10.1016 / S0140-6736 (14) 61176-4. PMID: 25131977.