From the July 2020 issue of HealthCare Business News magazine
The clinical case for remote monitoring
Despite the underutilization of remote CIED care, multiple studies and publications have clearly shown the superior benefits of RM versus IC models of care. We have transitioned from the 1971 model when transtelephonic monitoring captured battery and cardiac pacing data, to full-fledged device evaluation, where we can monitor effects of pacemaker therapy, lead fractures, atrial fibrillation burden, and status of heart failure intervention.
One of the largest device manufacturers estimates that 99.9% of their devices are now compatible with their remote monitoring network. For patients there is no need to travel to the clinic for routine CIED evaluations. Even better for the patient is that their CIED is evaluated daily through remote monitoring, versus once every 90-180 days based on their clinicians’ choice on how often they should return to the clinic for a follow-up exam.
There are multiple benefits to remote monitoring. Clinics benefit from not needing exam rooms, desk staff, parking space and cleaning of rooms between patients. Nurses and technical staff caring for this population can typically evaluate twice as many patients in a given time versus IC visits. Of significant value during a shortage of exam rooms or during a health crisis such as COVID-19, physicians and nurses can evaluate these patients outside of the traditional clinical setting. Already, an increasing number of hospital systems are allowing nurses to work remotely performing CIED checks, which has shown to increase productivity and staff satisfaction.
Clinicians and administrators should evaluate the clinical practice and make the necessary changes to monitor all existing and future CIED patients remotely. Implementation of remote monitoring into a clinic’s practice needs to be a priority. In the past, clinicians have given patients the option of IC or RM monitoring but all patients with CEIDs can be enrolled in RM, and the latest recommendations from various medical governing bodies advocate it immediately after implantation. Here’s how to convert routine existing IC visits to RM:
• Identify those who are enrolled in the remote monitoring program through the device manufacturer
• Contact patients who are enrolled, but who have not activated their device through their home networks, Wi-Fi source, cell phone adapter or land line to connect their system to the internet
• Identify those who have a CIED but are not enrolled in RM because they opted for IC visits