Page 3 Heart Failure Remote Monitoring Evidence From the Retrospective Evaluation of a Real World Remote Monitoring Program

Introduction

Despite the advances made in the management of heart failure, the burden of disease due to heart
failure still remains unacceptably high. Prevalence is projected to increase by 46% from 2012-2030 [1].

Data suggest that hospitalization and mortality rates did not change much from 2000-2010 [2]. Heart
failure contributed to about 1 in 9 causes of death in 2009, and it is estimated that about half the
825,000 new cases of heart failure diagnosed annually will die within 5 years of diagnosis [2]. The cost

of heart failure is also projected to increase by about 127% from the estimated US $30.7 billion spent in
2012 to US $69.7 billion in 2030 [1].
Given the magnitude of this problem, multidisciplinary approaches in the form of disease management
programs and other integrative models of care are recommended to optimize treatment outcomes [3].
Remote monitoring, either as structured telephone support or telemonitoring or a combination of both,

is fast becoming an integral part of many disease management programs [4-6]. The main strategy is to
either provide some sort of education around self-care, or monitor patients for early detection of heart
failure decompensation and intervention. Outcomes reported in the current heart failure telemonitoring

literature have varied not only based on the type of technology used but also on intensity, complexity of
intervention, speed of clinical decision-making, and patient-clinician factors. Telemonitoring approaches
vary from simple, noninvasive monitoring of physiologic parameters like heart rate, blood pressure, and
weight, to more advanced and invasive approaches like monitoring of intracardiac pressures [7].

An ideal heart failure remote monitoring approach would be one that empower patients for self-care—
knowing and able to perform day-to-day care processes, able to early identify symptoms of worsening of
disease, and initiating appropriate action. This can be achieved by a care model that incorporates
regular out-patient clinic follow-up with ongoing education (provided at clinic visits or via

telemonitoring), objective monitoring of clinical condition, and provision of timely feedback. The
telemonitoring program at the Partners HealthCare, Center for Connected Health, Connected Cardiac
Care Program (CCCP), is one of such programs that model this approach.

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