Improving Implanted Device Remote Monitoring Adherence Through Data Sharing
SESSION TITLE: EMERGING TECHNOLOGIES AND DISEASE MARKERS
Introduction: Congestive heart failure (CHF) patients with cardiac resynchronization therapy (CRT) devices do not always adhere to remote monitoring (RM). Utilization of RM has been found to improve health outcome while the lack thereof can delay clinical interventions to maintain optimum therapy.
Hypothesis: CRT patients currently do not have access to their own RM data. We assessed the hypothesis that CRT patients will become more adherent with RM if they are given access to their device data. We build an interactive report that engages patients by sharing their RM data. The goal was to improve RM adherence and empower patients to contact the clinic appropriately for low CRT pacing.
Methods: We applied a patient-centered design approach to create an interactive patient-facing RM report (Figure 1) in collaboration with CHF patients living with a CRT device and their informal caregivers. The iterative design process utilized participatory design and usability testing methods prior to enrolling a different group of patients in a 6-month pilot study. The study examined the impact of delivering this report via Epic’s patient portal, MyChart®. We collected MyChart® activity, calls to the clinic, report review frequency, healthcare utilization and RM adherence. Participant experience was gathered during exit interviews.
Results: 10 patients with an age range of 35-80 (mean 60) years participated in the study. The average adherence to RM prior to enrollment was 75% and increased to 91% by the end of the study. Participants on average accessed their report once every three weeks. Two participants received warning for low CRT pacing and appropriately contacted the clinic. At study exit all participants expressed realizing value from having access to the device data and wished to continue receiving reports.
Conclusion: Providing RM data to CRT patients had a positive impact on engagement and improved RM adherence
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Toscos, Tammy; Ahmed, Ryan; Wagner, Shauna; and Mirro, Michael MD, FACC, FHRS, FAHA, "Improving Implanted Device Remote Monitoring Adherence Through Data Sharing" (2019). Health Services and Informatics Research. 128.