SESSIONS » I.c eHEALTH FOR INDIVIDUALS / Telemedicine initiative – recent developments

Interrogating cardiac rhythm implants such as pacemakers or defibrillators from a distance, offers a wealth of opportunities in further improving therapy and enhancing patient safety. The clinical benefits from remote device monitoring were and still are subject to extensive clinical research and there is also an increasing body of evidence on the cost-effectiveness of this new therapy option. The presentation will report on the initial health economic findings as regards cardiac rhythm telemonitoring and it will sketch the potential for the future. Like many other e-health solutions, CRM telemonitoring holds the promise to make therapy better and to reduce societal costs. However, as the presentation will also critically show, reaping these benefits requires to identify all disincentives that are still in the way of full implentation of the technology and the will to remove them. Some of the financial disincentives have their origin in the silo budgets that are so typical for health care and that need to be overcome by innovative funding mechanisms. The presentation is intended to elaborate on the economic potential of CRM telemonitoring and to encourage Member States to fully exploit it by setting the right incentives.

Full text

Cardiovascular disorders are the leading cause of death. However, many cardiovascular conditions have changed towards chronic disease (cardiac insufficiency, heart rhythm disorders) increasing health care expenditures in Europe exponentially. Technology has dramatically evolved over the lasts years and many of these chronic patients are at present treated using implanted medical devices (pacemakers, defibrillators, cardiac resynchronizators, rhythm recorders). The possibility of continuous and remote monitoring of these devices has become available. This has opened the opportunity to plan for personalized health care, to create electronic medical recording, and to apply disease management in cardiovascular medicine. Permanent control of the clinical status of the patient will allow to predict acute decompensations, treating them at earlier stages and in many cases avoid hospitalization. Also, continuous control of the device will permit detection of device dysfunction (cable rupture, battery depletion, etc) at very early stage and to take immediate actions on them, thus significantly enhancing patient safety. The presentation will report on the clinical experiences using remote control of patients with 2 chronic conditions , arrhythmias and heart failure, and the developments that will be available in the near future. Patients will be followed and managed remotely independently of their physical location changing the relations between the patient and treating centre. The challenges of the development of a novel network which include patients, physicians, allied health professionals, health care providers, and administration. The several unmet needs, i.e. resources (technology, communication channels, personnel), definition of responsabilities, need for reimbursement , and changes in disease management which have to be discussed among stakeholders. Arrhythmias and related chronic diseases are ideal conditions for starting device and disease management; thus, patients with implanted medical devices will be the leading edge in a paradigm shift.

Full text