Implementation of a Home Monitoring System for Heart Failure Patients: A Feasibility Study.
BACKGROUND
Improving the management of patients with complex chronic disease is a substantial undertaking with the simultaneous goals of improving patient outcomes and controlling costs. Reducing avoidable hospitalization for such patients is a step toward both objectives. Some of the deterioration experienced in chronic disease patients occurs outside the view of their clinicians, and before the patient becomes overtly symptomatic. Home monitoring has been used for more than 20 years to detect deterioration earlier so that the patients could be treated before they became ill enough to require hospitalization. Patient participation is an important requirement for successful home monitoring. There has been some concern that patients would be unwilling or unable to engage in a program that collected multiple measurements. The Cedars-Sinai Cardiology Center provides a high-touch, intense management program for patients with congestive heart failure (CHF). A group of their patients were chosen to join a complex, multidevice home monitoring system to see whether such patients would find value in the additional effort.


OBJECTIVE
The objective of our study was to determine whether patients already actively engaged in a high-touch intensive management program for CHF would take on the additional burden of a complex home monitoring effort.


METHODS
A total of 20 patients from the Cedars-Sinai group were enrolled in a monitoring program utilizing 5 different devices. Anonymous surveys were collected from the patients to assess their satisfaction with the program.


RESULTS
In total, 90% (18/20) completed the program, and 61% (11/20) submitted the survey. Among the 18 patients, overall compliance with the requested measurements was 70%. It was found that 73% (8/11) felt better about their health as a result of the program, whereas another 73% (8/11) believed that the care team now had a better picture of their health.


CONCLUSIONS
Substantial patient compliance and satisfaction can be achieved in a sophisticated home monitoring program.
Sentrian, San Juan Capistrano, CA, United States.
Martin Steven
http://orcid.org/0000-0002-8489-6486
MS
Kohn
Sentrian, San Juan Capistrano, CA, United States.
Jeffrey
http://orcid.org/0000-0002-1726-8519
J
Haggard
Sentrian, San Juan Capistrano, CA, United States.
Jack
http://orcid.org/0000-0002-6133-3429
J
Kreindler
Cedars-Sinai Heart Institute, Beverly Hills, CA, United States.
Kade
http://orcid.org/0000-0002-7619-2657
K
Birkeland
Cedars-Sinai Heart Institute, Beverly Hills, CA, United States.
Ilan
http://orcid.org/0000-0002-0871-3713
I
Kedan
Cedars-Sinai Heart Institute, Beverly Hills, CA, United States.
Raymond
http://orcid.org/0000-0003-2090-0148
R
Zimmer
Cedars-Sinai Heart Institute, Beverly Hills, CA, United States.
Raj
http://orcid.org/0000-0003-0725-8648
R
Khandwalla
heart failure; home monitoring; patient engagement; predictive analytics