SWINDON, United Kingdom,

How Can Cardiac Device Practices Transition to Remote Monitoring?

By Matthew Swift, Lead Cardiac Physiologist CRM, Great Western Hospital


Remote monitoring - when managed appropriately - has always had the potential to streamline workflows for cardiac device specialists and their staffs. The ongoing COVID-19 pandemic however, has made the transition to more remote-based follow-up particularly urgent.

Social distancing requirements, and the intensified cleaning processes for patient rooms and PPE after each in-person follow-up, have put further workload pressures on already-strained clinics.

In 2009, my own clinic changed to a model where we use remote monitoring for close to 100 percent of our patients. This has since helped us manage the increasing demand for diagnostics, and our capacity pressures as we started seeing an uptick in ICD and CRT patients. It’s a model that has allowed us to manage the current pandemic by using remote monitoring to specifically target only those patients who really need face-to-face follow-up, such as those experiencing battery or lead placement issues, the rest have been able to stay safe at home. This has helped both us with managing clinic capacity, and our patients, who can avoid the mental and emotional stress of having to visit a physician during the pandemic unless absolutely necessary.

So how did we do it? The most important thing for our practice was moving to a paperless format, allowing our staff to manage records and deal with incoming alerts while working from home. Facilitating this change did require us to change some of our IT, administration, and even recruitment procedures. In the end, setting up remote monitoring for a patient needs to be quick and simple, with a pre-determined workflow that triages alerts, escalating critical ones quickly to the medical team. Specialists need to be very clear with patients about how remote monitoring works and what its limits are.

Although there are some initial challenges to setting up a remote monitoring first clinic, the benefits are worth the work. Firstly, the recent “At Home” study found no significant safety difference between pacemaker patients who were followed remotely through BIOTRONIK Home Monitoring and patients who were followed conventionally. As far as clinical workload is concerned, the RM-ALONE trial charted about a 40 percent reduction in staff workload, while also finding no significant difference in safety.

Additionally, in our experience, the service can pay for itself by helping to keep heart failure patients out of hospital. One recent Danish study that followed patients from 1998 to 2016 found that heart failure patients incurred an average of 17,000 euros in direct and indirect costs per year—almost three times the costs of an average patient in Denmark. With studies like IN-TIME, which demonstrated a 50 percent reduction in hospitalization for worsening heart failure, remote monitoring’s health and cost benefits are clear. As hospitals, health systems, and national economies work to recover from the initial COVID—19 shock, remote monitoring is poised to play a very helpful role.

I’ve recently talked through some of these benefits in a short video, to help other healthcare professionals understand how our processes have benefited from remote monitoring. To receive that video for free, sign up here.

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