Proving the Business Case for the Internet of Things

Remote monitoring improves heart patient care in New York

Steve Rogerson
February 28, 2017
A protocol that remotely monitors congestive heart failure patients in nursing facilities in New York uses automated alerts to notify cardiologists of significant changes in the patients' health. This is said to have dramatically reduced hospital readmissions while improving patient outcomes and keeping costs down.
The Hearts in Motion protocol, developed for the Allure Group by its chief medical officer Rekha Bhandari, Jeffrey Bander, and chief operating officer Melissa Powell, was shown to reduce hospital readmissions from skilled nursing home facilities from 31 per cent to seven per cent over a seven-month period, involving 152 patients. This was accomplished without increasing the cardiologist's presence onsite or associated costs.
"Research shows that approximately one-in-five Medicare recipients who are hospitalised for congestive heart failure are discharged to a skilled nursing facility for continued care,” said Bhandari. “Almost 25 per cent of these patients are readmitted to acute hospitals within 30 days. The heart failure protocol we developed and implement gives our patients top quality medical care compassionately and efficiently. The protocol will have significant and positive impacts on long term care. We are very proud of our accomplishments."
The protocol employs a remote system that uses real-time data to direct attending cardiologists to the patients in need of the most critical care. Upon admission to the nursing facility, a multidisciplinary team including a cardiologist, nurse and a rehab social worker were assigned to patients with history of cardiac disease. Staff members were educated regarding signs and symptoms of congestive heart failure, and strict protocols for measuring weights, renal function and brain natriuretic peptide (BNP) were established.
Monthly onsite team meetings and weekly webinars were conducted to review each patient's progress. Automated alerts were also setup to notify the cardiologist of significant patient weight changes or significant change to BNP and renal function. The physician then directed treatment based on these values and clinical information.
"Improving patient outcomes – reducing the number of readmissions for heart failure – is the primary benefit of the new protocol,” said Bander. “But not to be lost in this equation is how the protocol improves time and cost efficiency for doctors and staff. When the procedures are followed and closely monitored, we have been able to appropriate our resources more effectively and maximise care for patients who need it most throughout our care network. The implications for this moving forward are clearly positive."
Powell added: "The practical impact of this programme for our patients is that it brings the focus and detail of acute care to the sub-acute level. That means our treatment and caregiving can be more effective in keeping patients out of the hospital."
The Hearts in Motion protocol study was administered at five skilled nursing facilities in New York operated by the Allure Group.