Feasibility of Using an LVAD App to Engage Patients in Recovery Post Implant Discharge

Purpose VAD clinicians are highly utilized for routine questions from patients post implant discharge. Our team sought to develop an electronic monitoring system for LVAD patients similar to other surgical platforms to reduce healthcare utilization, increase patient engagement, and achieve behaviors to promote shared management of the LVAD system. Methods Our institution utilized the Twistle™ automated patient engagement application to send customized messages to LVAD patients post index hospitalization who had an IOS or Android supported phone. Messaging was sent daily x 2 weeks, every other day x 2 weeks for a maximum of 22 entries in the first 30 days. Patients entered VAD data, activity time and answered questions regarding fatigue, shortness of breath, dizziness and swelling. If a positive response was entered, the app prompted the patient to rate the symptom. Any messaging from the patient resulting in a negative response instructed the patient to call the VAD clinic. Results Fourteen LVAD patients participated (mean age 39 years, 91% male, 92% supported by HeartMate3™). The average patient engagement was 87%, 2 patients (14%) were readmitted within 30 days and the most reported symptom was fatigue. Nine (64%) patients chose to continue Twistle™ use after 30 days. Based on this small sample there was a tendency for patients with increased symptoms to be readmitted within 30 days. Conclusion Digital technology in the form of an LVAD app can be used to assess LVAD data alongside symptoms with a high rate of engagement. Use of an LVAD app has potential to improve patient care and identify high risk VAD patients to prevent readmission.