title: Web-based Internet telemedicine management of patients with heart failure.
abstract: An Internet-based store-and-retrieval telemedicine system to communicate between patients and their healthcare provider was tested. The system requires no specialized equipment, is Web-based, and allows frequent surveillance of the health status of the patients with heart failure (HF). Thirty six patients were recruited to evaluate a Web-based telemedicine system for reducing care encounters. Eighteen patients were randomized to the telemedicine arm (group T), and 18 were given usual clinical care (group C) in our HF center. Patients in group T reported three times weekly via a secure Internet site for telemedicine intervention. We studied patients with HF with New York Heart Association (NYHA) class 2 to 4 with hospitalization within past 6 months. Mean age was 56.1 +/- 12.6 years (66.7% male; 66.7% Caucasian, 27.8% African American, and 5.6% Hispanic). Mean ejection fraction (EF) was 23.9% +/- 17.6% in group T and 26.6% +/- 16.4% in group C. Over an 8-month period, unscheduled (group T-3; group C-5), and scheduled clinic visits (group T-11, group C-7) were similar (p = NS); one group T patient was transplanted, one group C patient died. Total hospital days were lower with group T (44 days) compared to group C (133 days), p < 0.05. An Internet-based telemedicine system was able to closely monitor patients with HF. Surveillance through Internet-based telemedicine resulted in less hospitalization compared to control patients. This system may be helpful in reducing the cost of HF patient care.
authors.affiliation: Section of Cardiology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
authors.forename: Abul
authors.initials: A
authors.lastname: Kashem
authors.forename: Marie T
authors.initials: MT
authors.lastname: Droogan
authors.forename: William P
authors.initials: WP
authors.lastname: Santamore
authors.forename: Joyce W
authors.initials: JW
authors.lastname: Wald
authors.forename: Judith F
authors.initials: JF
authors.lastname: Marble
authors.forename: Robert C
authors.initials: RC
authors.lastname: Cross
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Bove
mesh_terms: D016494:Computer Security; D019468:Disease Management; D005006:Ethnicity; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000208:ethnology / Q000628:therapy*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017216:Telemedicine