Telemedicine Saves the Lives of Coronary Patients

Pablo Valerio, International Business & IT Consultant | 4/19/2013 | 21 comments

Pablo Valerio
While healthcare companies are struggling to show the ROI of electronics records, there is significantly more progress in mobile health and telemedicine. The Mar-Litoral Integrated Heart Failure Program at Hospital del Mar in Barcelona (ICOR) is helping to improve the quality of life of chronic patients while cutting costs.

Started in 2010 with 200 high-risk patients, the program uses simple technology, including a touch-screen computer with a connected bluetooth scale and a blood pressure monitor to keep track of the progress of patients daily. The patient uses the scale and monitor to transmit the information to the hospital, and answers eight simple questions about his condition. An algorithm checks the information against the patient's database and determines if any action is required. Patients are also required to have a short weekly videoconference with a specialized nurse. If a patient misses a day, a nurse calls to check in, and when necessary, the doctor and patient connect on a video conference. Patients also receive important information about diet, suggested exercise, and friendly reminders to take their medication.

Here is a short video (in Spanish) about the program.

The program was showcased at the recent Mobile World Congress in Bacelona during the seminar "mHealth making a positive difference to end users." The results were quite promising.

"Preliminary results indicate a reduction of 34% in the mortality rate and 63% in the readmission rate. Also we observed a reduction of 41% of readmissions for other reasons, and the cost per patient has dropped 68%," said Dr. Josep Comin, director of the Chronic Heart Failure unit, who added, "It is important to point out the high level of satisfaction of the patients in this project: they feel better monitored and safer. The results show the benefits of telemedicine for old people, regardless of their limited experience with electronic devices." [Editor's Note: translation by author.]

The average cost of treatment of a high-risk chronic heart failure patient is about €14,000 per year for the Catalonian Health Service; that includes hospital visits, doctor and nurses' time, and tests. With the ICOR program the average cost per patient was reduced to €4,500 per year.

Telemedicine and m-health are becoming increasingly important to improve management and care of chronic patients, and as the population grows older, imperative to reduce the increasing cost of care for those patients. According to a new report titled "World Market for Diagnostic Cardiology Devices and Remote Cardiac Monitoring Services -- 2013" from IHS inMedica, the cost of remote cardiac monitoring is expected to rise to $867 million just in the United States.

If the simple application of well-known technology can reduce costs and save lives, it is imperative that CIOs begin paying attention to the success of such programs. While struggling with meaningful use or EHR, here's a technology you can implement easily and cheaply that can help reduce the pressure on your more complicated projects. If that's not enough, saving lives should be a good incentive.

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MDMConsult   Telemedicine Saves the Lives of Coronary Patients   7/10/2013 2:46:26 AM
Re: progressive medicine
If the push towards regulatory reform for state medical licensing and further encouragement to adopt telemedicine technologies continues this is always a positive future outlook. Regulatory barriers are difficult in cost of obtaining licensure across multiple states, malpractice protection, etc al. Lack of acceptance by government hinders on the healthcare system. Professional and cultural barriers occur from decreased lack of desire or physicians not being able to adapt internally for telemedicine. 
Henrisha   Telemedicine Saves the Lives of Coronary Patients   5/3/2013 5:42:18 AM
Re: progressive medicine
@Pubudu makes a good point. A lot of elderly people I know seem to have an aversion to technology. Not because they don't appreciate or understand the benefits, but because they have difficulty using the devices. Pushing for simplicity and an easy-to-use interfact should be key.
Henrisha   Telemedicine Saves the Lives of Coronary Patients   5/3/2013 5:41:22 AM
Re: impressed
The numbers are truly impressive. They should be enough to bolster interest in the technology and hopefully speed up its development and roll-out.
Susan Nunziata   Telemedicine Saves the Lives of Coronary Patients   4/30/2013 1:09:48 AM
Re: telemedicine bright future.
@Pablo: This is an important concern. This is why there needs to be some basic standards and assurances of interoperability to be truly successful.
Susan Nunziata   Telemedicine Saves the Lives of Coronary Patients   4/30/2013 1:08:21 AM
Re: telemedicine bright future.
@Pedro: this is a great example of what can be accomplished, such solutions can be applied to management and help for those with other chronic ailments such as diabetes, for example.

The simplicity of any such system is going to be key to its success, especially when it comes to helping geriatric patients.
Susan Nunziata   Telemedicine Saves the Lives of Coronary Patients   4/30/2013 1:03:42 AM
Re: progressive medicine
@vnewman: Thanks for sharing your personal story. It's a clear example of how technology can be used to help patients with chronic illness and also hopefully reduce the stress of having to make multiple visits to the hospital.

This seems like such a clearly beneficial application with relatively low risk that I hope it will be quickly embraced by other healthcare operations. Seems like a win for everybody.
vnewman   Telemedicine Saves the Lives of Coronary Patients   4/29/2013 9:26:12 PM
Re: progressive medicine
"Patients also receive important information about diet, suggested exercise, and friendly reminders to take their medication."

It's the trifecta of maintaining good cardiovascular health for a heart patient: diet, exercise, and taking medication.  Non-compliance by patients to routines are a huge hurdle in caring for coronary patients.  It is very easy for those patients who aren't being micro-managed to fall into bad habits that can sabotage their heart health.  

I've seen this first-hand with my father-in-law who had: first a heart attack, a pacemaker, an LVAD (Left ventricle assist device), then a heart transplant.  Going from 6 months of nearly round-the-clock care in hospitals and rehab centers to being nearly on his own made it really wasy for him to fall off the wagon.  Missing medication can be a life or death situation and he's ended up in the hosptial a few times because of it.  It would be nice to give him a not-so-invasive nudge like his.
Pubudu   Telemedicine Saves the Lives of Coronary Patients   4/23/2013 12:05:03 PM
Re: progressive medicine
True impactnow, But I feel that there will be a technological issues with the older patients because they may not familiar with the new technology, But still it much more easier even thou they have a assistance with someone. 
kstaron   Telemedicine Saves the Lives of Coronary Patients   4/22/2013 3:35:35 PM
I'm impressed by these numbers. A reduction of $10000 per patient and over 30% improvement in mortality rate is a great start to using new technology.
Pubudu   Telemedicine Saves the Lives of Coronary Patients   4/22/2013 1:28:50 PM
Re: telemedicine bright future.
Peblo I thing that this system will also can be used for the other medical problems as well except mental issues(that is also possible with the help of a third party from a patient) rather than using or only for a coronary patients.
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