title: Follow-up and treatment of an instable patient with heart failure using telemonitoring and a computerised disease management system: a case report.
abstract: In the last decades, the introduction of information and communication technology (ICT) in healthcare promised an improved quality of care while reducing workload and improving cost-effectiveness. This might be realised by the use of computer guided decision support systems and telemonitoring. This case study describes the process of care of a patient with chronic heart failure, who was treated with a computerised disease management system in combination with telemonitoring. With the help of these appliances, we think we were probably able to prevent at least two readmissions for heart failure in a period of 10 months. We also gained more insight into patient's behaviour with regards to compliance with the heart failure regimen at home. Frequent contact at distance and the online availability of physiological measurements at home facilitated patient tailored education and helped the patient to react adequately to symptoms of deterioration. Additionally, up-titration of heart failure medication was performed without contacting the patient at the outpatient clinic.
authors.affiliation: Department of Cardiology, University Medical Centre Groningen, University of Groningen, The Netherlands. a.e.de.vries@thorax.umcg.nl
authors.forename: Arjen E
authors.initials: AE
authors.lastname: de Vries
authors.forename: Martje Hl
authors.initials: MH
authors.lastname: van der Wal
authors.forename: Wendy
authors.initials: W
authors.lastname: Bedijn
authors.forename: Richard M
authors.initials: RM
authors.lastname: de Jong
authors.forename: Rene B
authors.initials: RB
authors.lastname: van Dijk
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D019090:Case Management; D057210:Delayed Diagnosis / Q000009:adverse effects; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D009426:Netherlands; D010349:Patient Compliance; D012720:Severity of Illness Index; D017216:Telemedicine / Q000706:statistics & numerical data*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013997:Time Factors