Despite remote monitoring advantages, some still want to see the doc

Study cites effectiveness, reduced costs for patients with cardiac devices
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Remote monitoring can be an effective part of follow-up care for patients with implantable electronic cardiovascular devices, according to a small study recently published in the journal Telemedicine and e-Health.

In the study, which compares in-office visits and remote visits, patients reported a high level of satisfaction with remote monitoring, though eight of the 15 participants (53 percent) said they preferred in-office visits.

The need for follow-up care is growing as implantable electronic cardiovascular devices proliferate, adding to the staff needed to do so. Between visits, however, physicians have no idea how well the devices are working unless the patient reports a problem.

This study looked at the feasibility of using Medtronic's CareLink remote monitoring system between in-office visits, focusing on both clinical (event detection and time to diagnosis) and nonclinical (patient's satisfaction and economic costs) aspects. The system wirelessly collects data from implanted devices, then relays it through an analog phone line to secure servers that present the information to authorized clinicians on a website.

Patients underwent two in-office visits and two remote evaluations, reproducing one year of clinical follow-up.

Fifteen problems were detected, nine by remote monitoring and six by patients. Only nine produced systems. Remote monitoring detected both symptomatic and asymptomatic events, while patients reported only issues that produced symptoms. 

In addition, the remote monitoring technology has the ability to reduce total follow-up costs for patients by 25 percent, the researchers found. Despite giving the technology high marks, eight patients preferred seeing the doctor in person, four preferred remote monitoring and three had no preference.

A recent report from Deloitte Center for Health Solutions predicted that wireless monitoring technologies will save nearly $200 billion by managing chronic diseases in the U.S. over the next 25 years. The report cites other estimates that suggest remote monitoring can reduce the costs for caring for the elderly in rural areas by allowing seniors to live independently, reducing the need for face to-face medical consultations by 25 percent.

Telemedicine provides the potential to give care to patients in remote areas, eliminating travel and inconvenience. In its push to expand telemedicine services, the U.S. Department of Veterans Affairs is finding that patients of its mental health services tend to choose the remote sessions over face-to-face sessions.

To learn more:
- read the research

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