title: Remote monitoring costs, benefits, and reimbursement: a European perspective.
abstract: OBJECTIVE
  To provide a European perspective on reimbursement issues surrounding remote monitoring of cardiac implantable electronic devices in view of the anticipated costs and benefits.
  
  
  RESULTS
  Review of recent literature addressing clinical, economic, sociocultural, and technological factors associated with remote monitoring. When healthcare transformation is urgently needed, remote monitoring offers opportunities to innovate and cope with escalating costs and constrained resources, while improving patient safety, quality, and access to care as reflected in clinical studies. The introduction of remote monitoring into daily practice requires analysis of reimbursement policies to address funding scope, payment method, payer, price and allocation, and alignment with health system objectives and goals to ensure financial and operational sustainability of resources, infrastructure, and processes. Remote monitoring policies should gradually transition from activity-based, added-value services in a care-and-cure setting, to performance and outcome-oriented highlighting prevention, surveillance, and empowerment. By encouraging and rewarding innovation and interoperability, proprietary remote monitoring technologies can open up using standards and connect to support a growing evidence base that guides clinical decision support and planning of future policies.
  
  
  CONCLUSIONS
  Careful planning, sharing of experiences, and gradual adoption of reimbursement models that focus on outcome, performance, and cost-effectiveness are key aspects of containing escalating costs and improving quality and access to healthcare. Despite differences in health systems and payment methods in Europe, policy-makers, professional societies, payers, providers, and the industry need to join forces to transform healthcare and make innovation happen.
authors.affiliation: FORTH, Institute of Computer Science, Heraklion, Crete, Greece.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Chronaki
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics*; D015716:Electrocardiography, Ambulatory / Q000191:economics* / Q000295:instrumentation; D019544:Equipment Failure Analysis / Q000191:economics; D005060:Europe / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D010138:Pacemaker, Artificial / Q000191:economics*; D011358:Product Surveillance, Postmarketing / Q000191:economics*; D017216:Telemedicine / Q000191:economics* / Q000295:instrumentation
keywords: Cardiac implantable electronic devices; Cost-effectiveness; Reimbursement; Remote follow-up; Remote monitoring