The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.)

Abstract

Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient’s prognosis and quality of life.Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30–35% reduction in mortality and 15–20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional ‘chronic care model’. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity.Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure.By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation

Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomised controlled trial

“…Providing objective feedback data and allowing patients to track their own progress can improve patients’ self-management skills and thereby improve their adherence. It is convenient, can reduce anxiety, and improve the quality of life and prognosis of patients with low medical costs compared with conventional ER without monitoring 9–13…”

Telemedicine in Cardiology. Part 1. Personal Electrocardiogram Telemonitoring in Outpatient Practice: An Optimal Approach

“…Современные представления о возможностях и методах удаленного наблюдения за пациентами с сердечно-сосудистыми заболеваниями обобщены в документах рабочей группы по цифровой кардиологии Европейского кардиологичес-кого общества [10], консенсусном документе Итальянского кардио логического общества и Итальянского общества телемедицины и электронного здравоохранения [13], в согласованном заключении экспертов International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society (ISHNE/HRS) 2017 г. по амбулаторному мониторированию ЭКГ и наружному мониторированию деятельности сердца/ телеметрии [7], а также в отечественных и зарубежных рекомендациях по диаг ностике и лечению нарушений ритма сердца (НРС) [14][15][16][17], синкопе [17][18][19], АГ [20], ХСН [7,13]. Телемониторирование ЭКГ становится не только средством решения практических задач, но и инструментом научных проектов [21][22][23][24][25].…”

Telemedicine for Chronic Heart Failure: An Update

“…Particular applications of AI include expert systems, speech recognition, and machine vision. I) and small-sized patient samples (between 50 and 1000 patients), with very short follow-up periods (between 3 months and 1 year) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Moreover, most of these studies were based only on weight variations, without including other warning or monitoring parameters (see Table 2).…”

“…Aside from these medical considerations, it is worth noting that all the studies seem to agree that using telemedicine solutions in CHF management proved at least economically beneficial (Table 1) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Depending on the study, the savings were estimated at between $5000 and >$50,000/year/patient according to the CHF stage and study setting.…”