After decades of innovation in cardiovascular care and reductions in mortality, deaths due to cardiovascular disease have started to increase again in the United States, driven by patients in rural communities who have less access to healthcare resources1(Figure 1). While acute life-saving therapies are better than ever before, chronic aftercare remains a challenge and is complex for patients to understand and navigate. Remote patient monitoring with telehealth holds the promise of addressing multiple points of failure along the spectrum of the cardiovascular care continuum as we face increasing rates of cardiovascular disease burden and wide disparities in the apportioning of healthcare resources.
Rising cardiovascular disease mortality rates for people who are living in rural areas, middle-aged (45–54 years of age), and white. Authors’ analysis using data from the National Vital Statistics System.3
Source: Call to Action: Urgent Challenges in Cardiovascular Disease: A Presidential Advisory From the American Heart Association, Mark McClellan, Nancy Brown, Robert M. Califf, John J. Warner; Jan2019; Circulation. 2019;139:e44–e54
The importance of remote patient monitoring:
It is well-known that patients with chronic illnesses, like congestive heart failure, have improved survival, less hospital admissions and better quality of life measures when they are more engaged with their self-management with the help of care coordinators and caregivers3. Given the proliferation of web-based devices and sensors which have become relatively easy for patients to utilize, remote patient monitoring provides the technology required to sufficiently engage patients with caregivers, who can use such platforms for both objective and subjective assessments of their chronic illnesses. The implementation of a well-designed remote patient monitoring platform has been cited as one of the key interventions capable of addressing the multiple points of failure that exists in the care continuum of cardiovascular disease1
IntelliH has the necessary features to address nearly all of the cited failure points in cardiac care.
IntelliH is a SaaS based Remote Patient Monitoring platform with a focus on proactively managing chronic cardiac conditions like CHF. It provides a risk stratified dashboard for care coordinators on PC, MAC and Android tablets. The intelliHpatient App on iOS and Android devices wirelessly collects physiological data from monitoring devices such as Weight Scales, Pulse Oximeters, Blood Pressure Monitors, Thermometers as well as Glucometers and sends that to IntelliH on the cloud for analysis. The IntelliH platform tracks care plans, analyzes received vitals and generates alerts that are customized to an individual patient. It prepares a comprehensive disease specific report for doctors to analyze across any longitudinal period. The IntelliH solution enables immersive collaboration with patients, care givers and care teams through rich telehealth videos as well as secure texts.
IntelliH addresses failure points by closing the gaps:
Focusing on preventive treatments across populations can have dramatic effects on reducing cardiovascular disease burden.This further translates into reduced healthcare expenditure per patient which in turn is a significant source of bonus revenue for healthcare systems participating in shared savings programs. intelliHwas constructed with the understanding that bringing patients closer to their caregivers through the platform in the clinical context of the incoming vitals data would possibly alter the course of their illness and avert adverse outcomes compared to traditional fragmented, episodic care. Specific failure points have been identified by the American Heart Association1 and intelliH has functions that are capable of meeting the needs they have identified (Figure 2):
The Importance of Care Co-ordination:
When patients are diagnosed with their chronic illnesses, usually in the inpatient setting, and have to go home and manage a complicated medication regimen which is largely foreign to them, they are faced with the daunting challenge of having to navigate a complex healthcare system of which they often have little education about. A system of care coordination after discharge from the acute care setting is vital to ensure that patients do not succumb to decompensation from their illness due to a lack of sufficient understanding of how to use their treatment recommendations. The following four characteristics of an optimal care-coordination system, all of which are successfully addressed by intelliH, have been shown to improve outcomes2:
The burden of cardiovascular disease continues to increase in the United States. The supply of cardiologists, however, to address this demand is insufficient4. Furthermore, the training of the workforce may not be sufficiently calibrated to address the specific needs of the increasing prevalence of chronic cardiovascular disease. Several solutions have been proposed to address this problem. Twoin particular are addressed by the architecture of intelliH. First, cardiologists should be integratedwithin a care team comprising of primary care physicians, nurse practitioners, physician assistants and pharmacists. Second, prevention should be a focus to reduce the subsequent proliferation of cardiovascular disease that occurs without the appropriate management of risk factors. intelliH was built to create care teams and improve care coordination with the purpose of managing chronic cardiovascular disease with the timely management of risk factors through real-time analysis of vitals. While the acute shortage of cardiologists will take some time to address, technology such as that present in intelliHhas the potential to make the existing workforce more efficient to help bridge the supply and demand mismatch that exists today in the cardiology workforce.
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