title: Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.
abstract: BACKGROUND
  Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization.
  
  
  METHODS
  Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison.
  
  
  RESULTS
  HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort.
  
  
  CONCLUSIONS
  The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.
authors.affiliation: 1 National Cancer Institute , National Institutes of Health, Rockville, Maryland.
authors.forename: William T
authors.initials: WT
authors.lastname: Riley
authors.forename: Pamela
authors.initials: P
authors.lastname: Keberlein
authors.forename: Gigi
authors.initials: G
authors.lastname: Sorenson
authors.forename: Sailor
authors.initials: S
authors.lastname: Mohler
authors.forename: Blake
authors.initials: B
authors.lastname: Tye
authors.forename: A Susana
authors.initials: AS
authors.lastname: Ramirez
authors.forename: Mark
authors.initials: M
authors.lastname: Carroll
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017046:Cost Savings; D005260:Female; D017048:Health Care Costs; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015397:Program Evaluation; D019114:Remote Consultation / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D016019:Survival Analysis
keywords: cardiology/cardiovascular; home health monitoring; mobile health; telecardiology; telemedicine