Healthcare providers around the globe are tasked every day with ensuring they deliver safe and effective care to their patients. Once outside the four walls of the hospital, where continuous oversight is a part of this care, management of the patient becomes much more challenging.
Primary care physicians (PCPs) are placed in a role of general supervision, while their specialist counterparts, like cardiology, are able to narrow their focus.
Cardiologists assume the responsibility for managing care of some of the most medically fragile patients in America.
According to the Centers for Disease Control (CDC), heart disease is still the leading cause of death in the United States, with a person dying every 33 seconds from its wake (1).
A Case for Monitoring Atrial Fibrillation
Atrial fibrillation (AFib) is the most common arrhythmia, with heart disease being a top risk factor, and it is estimated that 12 million people will have AFib by 2030 (2). Atrial fibrillation is linked with a fivefold increased risk of stroke, which makes early detection even more crucial (3). Patients who seek the care of a cardiologist are often referred by their PCP or are seeking care after a hospital admission. These patients typically qualify for short-term continuous wave from monitoring in the form of an event monitor worn for 24-72 hours and then monitoring is discontinued.
Most patients schedule their cardiology appointments every 3-6 months depending on their condition. Patients at risk for dangerous arrhythmias are sent home without a solution to RE-connect them to their provider and this gap in patient oversight can be dangerous for patients and frustrating for providers.
Earlier this year, Nevada Cardiology Associates decided to take action to close this gap, seeking to improve patient care and impact outcomes. The cardiology team and lead cardiologist provided the clinical team from Lohman direct insight into the daily ECG monitoring program for effectiveness and outcomes. For privacy purposes, specific details regarding patient population, size, and personal information have been removed from this use case summary.
The clinical team from Lohman Technologies worked hand-in-hand with the cardiology team to develop the daily ECG monitoring for a select group of patients. As we collectively improve the patient and provider relationship with the clinical impact of daily ECG readings, the physician champion had this to say;
“Our patients need an ECG device that is easy to use and that can send data to my team immediately so we can interpret the results and intervene quickly if needed.”
- Dr. Robert L. Baker, M.D., FACC
The Lohman clinical team developed the program for monitoring, communicating, and documenting daily ECG rhythms that fit seamlessly into the staff’s existing workflows. The goal of the program was to identify the impact of daily ECG readings on the quality of patient care.
The Use Case for Daily Oversight
Patients were selected and given a HomECG+ device for daily monitoring of their cardiac rhythms along with other various times as directed by clinical staff. Patients were brought into the office to be educated on the program and the device to ensure understanding of use and improve compliance. Ease-of-use for all patient types was a critical factor for the program. The HomECG+ device has built in cellular technology, which eliminates the need for a cell phone and related app. The device and readings could be taken anytime from anywhere.
One patient had this to say, “I had another device that I bought online, it was very expensive, and I could never use it because I had an older iPhone and it wouldn’t work with that.”
Throughout the program, the cardiologist’s clinical staff was able to see 45-second ECG readings on a dashboard within minutes of completion. They maintained two-way communication with patients, and upon receiving ECG rhythms that yielded an AFib result, were able to react quickly and direct the patient to next steps. The Lohman clinical team reviewed data collected after 90 days of daily use from the patients and the results were eye-opening.
What is the Clinical Impact of Daily ECG Readings? A Small Daily Act Yields Big Outcomes:
ECG data and patient medical records were reviewed for all the patients who participated in the program, all with various risk factors for developing atrial fibrillation. Demographics included female and male patients with ages ranging from 30-78, and a median age of 67. Patients were placed in the program with a rolling start date and data was collected for approximately 90 days.
A total of 910 ECGs were taken, with 186 of those yielding a result of atrial fibrillation.
Of all the patients in the program, half of them experienced atrial fibrillation enabling the lead cardiologist and his team to intervene immediately and direct a course of treatment. The following are synopses of select patient encounters utilizing the HomECG+ data:
ECG data was used to direct patients on activity restrictions.
Patients who went into AFib started new medication.
Medications were changed via phone communication; office visit was scheduled; Lexiscan stress test and 12-Lead ECG performed, medication changed again.
A patient suffered a leg injury and was admitted to a local hospital orthopedic floor. The patient was not being monitored in the hospital but started having palpitations and used his HomECG+ and was found to be in AFib. The patient called the lead cardiologist who connected via telehealth visit.
Patient had an episode of AFib and started on a beta blocker and blood thinner and brought in later in the week for tests.
Patient had an episode of AFib, and the lead cardiologist followed-up via phone, reviewed tracings, then directed the patient to the ER.
Changing the Home ECG Monitoring Ecosystem.
The vision with the HomECG+ is to impact the care continuum through our innovative, patient-centric, interoperable AFib detection device and remote cardiac monitoring solution.
To learn more about the HomECG+ Solution -- reach out to our partnership team by filling out this brief form.
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DISCLAIMER: This content does not provide medical advice or is an attempt to practice medicine. Please consult a healthcare professional for medical assistance if you think you are experiencing AFib or may be at risk for AFib.