title: Workload and usefulness of daily, centralized home monitoring for patients treated with CIEDs: results of the MoniC (Model Project Monitor Centre) prospective multicentre study.
abstract: OBJECTIVE
  Automated, daily Home Monitoring (HM) of pacemaker and implantable cardioverter-defibrillator (ICD) patients can improve patient care. Yet, HM introduction to routine clinical practice is challenged by resource allocation for regular HM data review. We tested the feasibility, safety, workload, and clinical usefulness of a centralized HM model consisting of one monitor centre and nine satellite clinics.
  
  
  RESULTS
  Having no knowledge about patients' clinical data, a telemonitoring nurse (TN) and a supporting physician at the monitor centre screened and filtered HM data in 62 pacemaker and 59 ICD patients from nine satellite clinics for over 1 year. Basic screening of arrhythmic and technical events required 25.7 min (TN) and 0.7 min (physician) per working day, normalized for 100 patients monitored. Communication of relevant events to satellite clinics per email or phone required additional 4.3 min (TN) and 0.4 min (physician). Telemonitoring nurse also screened for abnormal developments in longitudinal data trends weekly for 3 months after implantation, and then monthly; one patient session lasted 4.0 ± 2.9 min. To handle transmission-gap notifications, TN needed additional 2.8 min daily. Satellite clinics received 231.3 observations from the monitor centre per 100 patients/year, which prompted 86.3 patient contacts or intensive HM screening periods by the satellite clinic itself (37.3% response rate), 51.7 extra follow-up controls (22.3%), and 30.1 clinical interventions (13.0%).
  
  
  CONCLUSIONS
  Centralized HM was feasible, reliable, safe, and clinically useful. Basic screening and communication of relevant arrhythmic and technical events required a total of 30 min (TN) and 1.1 min (physician) daily per 100 patients monitored.
authors.affiliation: Department of Cardiology and Angiology, Charite Campus Mitte, Charite Centre 11 Internal Medicine, Charite Universitätsmedizin Berlin, Berlin, Germany. vogtmann@kardiologie-potsdam.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogtmann
authors.forename: Sascha
authors.initials: S
authors.lastname: Stiller
authors.forename: Andrea
authors.initials: A
authors.lastname: Marek
authors.forename: Stefanie
authors.initials: S
authors.lastname: Kespohl
authors.forename: Michael
authors.initials: M
authors.lastname: Gomer
authors.forename: Volker
authors.initials: V
authors.lastname: Kühlkamp
authors.forename: Göran
authors.initials: G
authors.lastname: Zach
authors.forename: Steffen
authors.initials: S
authors.lastname: Löscher
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D001145:Arrhythmias, Cardiac / Q000451:nursing / Q000628:therapy*; D002309:Cardiology; D017147:Defibrillators, Implantable; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D015233:Models, Statistical; D008991:Monitoring, Physiologic / Q000009:adverse effects / Q000379:methods*; D010138:Pacemaker, Artificial; D015397:Program Evaluation; D013041:Specialties, Nursing; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D013689:Telephone; D016526:Workload / Q000706:statistics & numerical data