title: Is telemedicine an answer to reducing 30-day readmission rates post-acute myocardial infarction?
abstract: BACKGROUND
  Patients hospitalized for an acute myocardial infarction (AMI) are at risk for early readmission. Readmission rates in the community reportedly reach approximately 20%, and 30-day readmission rates have become a quality-of-care marker. Telemedicine is one strategy for improving clinical outcomes by offering real-time biometrics tracking and rapid intervention. We retrospectively assessed the 30-day readmission rate of post-AMI members of a telemedicine system.
  
  
  METHODS
  All "SHL"-Telemedicine subscribers who sustained an AMI and those who became subscribers within 10 days from discharge post-AMI between 2009 and 2012 were assessed. Their files were reviewed for demographics, coronary risk factors, reasons for readmission, and discharge diagnoses.
  
  
  RESULTS
  In total, 897 suitable patients (mean age, 62±14 years; 81% males) were included. They had made 3,318 calls to the monitor center for consultation. A mobile intensive care unit was dispatched for 158 patients, 64 were transported to the hospital, and 52 (5.8%) were readmitted (10 patients were readmitted twice). Thirty-five readmissions were for noncardiac reasons. Twelve patients had acute coronary syndrome (11 were revascularized). Readmission rates were higher in patients with repeat AMIs (11.9% versus 5.3% among those with no AMI history) and in females (9.6% versus 4.9% among males). Unlike published figures for the general population, there were no significant differences between readmitted and non-readmitted patients regarding diabetes, hypertension, or congestive heart failure.
  
  
  CONCLUSIONS
  Telemedicine technology shows considerable promise for reducing 30-day readmission rates of post-AMI patients.
authors.affiliation: 1 Department of Cardiology, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Eyal
authors.initials: E
authors.lastname: Ben-Assa
authors.forename: Yacov
authors.initials: Y
authors.lastname: Shacham
authors.forename: Michal
authors.initials: M
authors.lastname: Golovner
authors.forename: Nomi
authors.initials: N
authors.lastname: Malov
authors.forename: Eran
authors.initials: E
authors.lastname: Leshem-Rubinow
authors.forename: Avivit
authors.initials: A
authors.lastname: Zatelman
authors.forename: Ayelet
authors.initials: A
authors.lastname: Oren Shamir
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.forename: Arie
authors.initials: A
authors.lastname: Roth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D017216:Telemedicine / Q000706:statistics & numerical data*
keywords: acute myocardial infarction; readmission; telemedicine