Partners Connected Health Remote Monitoring Program for Heart Failure Patients Significantly Lowers Hospital Admissions and Mortality Rates; Less Intensive Remote Monitoring Follow-Up May Improve Long-Term Outcomes
Study published in the April issue of the Journal of Medical Internet Research
A recent study to evaluate the effectiveness of a remote monitoring program for heart failure patients conducted by Partners HealthCare Connected Health demonstrated significantly lower hospitalization and mortality rates, for up to 90 days and 120 days after discharge, respectively. Partners' Connected Cardiac Care Program (CCCP) is a four-month remote monitoring and education program designed to improve the management of heart failure patients at risk for hospitalization. The study was published in the April issue of the Journal of Medical Internet Research (Vol 17, No 4 (2015): April).
The retrospective analysis included patients enrolled in the Connected Cardiac Care program at Massachusetts General Hospital, and were matched one-to-one with usual care patients. There were a total of 348 patients enrolled. Although significantly lower hospital and mortality rates were achieved for the duration of the remote monitoring program, those effects did not persist beyond the 120-day program.
"These findings suggest that our Connected Cardiac Care remote monitoring program successfully reduced hospitalization and mortality rates during the four-month program, and kept more patients alive by allowing for earlier detection of symptoms of worsening disease and just-in-time intervention," said Kamal Jethwani, MD, MPH, Senior Director of Connected Health Innovation at Partners HealthCare.
The hospitalization rates for both the intervention and control groups were similar at baseline; hospitalizations decreased dramatically in the CCCP group compared to the control group throughout the duration of the four-month remote monitoring program. Mortality rates were also significantly lower in the remote monitoring group compared with the control group at the end of the program. At the one-year follow up, hospitalizations did not differ significantly by group; the mean length of hospital stay was also similar in both groups.
"Although it started nearly ten years ago as just a pilot, the Connected Cardiac Care Program has become an important clinical strategy that has improved the lives of thousands of heart failure patients. At Partners HealthCare at Home, we strongly believe in the potential of telemonitoring to improve our ability to care for patients, as well as improve outcomes, which we have proven through this analysis," added Keren Diamond, RN, BSN, MBA, Chief Operating Officer, Partners HealthCare at Home.
Following patients an additional eight months after program completion showed that hospitalization rates increased among the remote monitoring group, but were not significantly different compared to controls. Although not statistically significant, mortality rates over one-year follow up were lower in the remote monitoring group.
"We speculate that the longer-term findings could be explained by the progressive nature of the disease and early death of patients with advanced disease in the control group. Better-informed patients may become more sensitized to symptoms of disease progression and present earlier to their physician than patients not exposed to regular disease-related education and monitoring, which may also explain higher hospitalization rates among patients completing the remote monitoring program," added Dr. Jethwani.
"With our hospitals liable for thirty-day readmissions through CMS penalties, such interventions are becoming mainstay in the management of high risk patients," added Joseph C. Kvedar, MD, Vice President, Connected Health, Partners HealthCare."As health technologies become more accessible and commoditized, programs like Connected Cardiac Care will be more affordable, and achieve an obvious return on investment."
Although mortality rates increased in the remote monitoring group after program completion, the overall effect was still beneficial compared to controls over the one-year follow up. Similar findings were also reported in eight meta-analyses published between 2007 and 2013 evaluating the effect of remote monitoring on mortality.
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Partners is leveraging information technology – cell phones, computers, wearables, sensors and remote health monitoring tools – to deliver quality patient care outside of traditional medical settings. Partners Connected Health programs are also helping providers and patients better manage chronic conditions, maintain health and wellness and improve adherence, engagement and clinical outcomes. The Connected Health team creates and deploys mobile technologies in a number of patient populations and care settings, and is conducting innovative clinical studies to test the effectiveness of mobile health technologies in various clinical applications, including medication adherence, care coordination, chronic disease management, and prevention and wellness. Visit www.partners.org/connectedhealth.