Ambulantes Krankheitsmanagement bei kardiologischen Patienten: 12 Monate Nachverfolgung von Telemedizinischem Monitoring in Thüringen mit dem Betreuungsprogramm Zertiva®

PURPOSE: We report on our experience with ambulatory Home Care Telemedicine in chronic heart failure and unclear arrhythmias and its cost effectiveness if used additionally to standard care. MATERIALS AND METHODS: In this study a 12 month follow up of Home Care Telemedicine in cardiology was performed in 95 patients in Thuringia. (25 female, 65±16 and 70 male, 67±9 years). Patients got a mobile 12-channel ECG, 5 with suspected paroxsysmale tachycardia, 90 with chronic heart failure (70 NYHA I und II, 20 NYHA III), NYHA III patients additionally transmitted vital parameters weight, blood pressure and pulse on a daily base. In case of acute problems the ambulatory ECG was transferred and a physician in the telemedicine centre could be reached 24 h a day. The rate of rehospitalization was compared to a matched control group. RESULTS: 283 emergency calls were registered, 42% outside work hours (workdays 8.00-18.00). In 74% cases an advice was given, in 20% a referral to the general practitioner was recommended on the next day, only 6% were referred the hospital or an ambulance was called. The rate, duration and costs of rehospitalizations were significantly lower in the telemedicine group. DISCUSSION: Shortening of resources in stationary care capacity in an increasingly older population requires new approaches for ambulatory disease management particularly for chronic affected patients. Such an opportunity for monitoring chronic heart failures additionally to hospital care, general practitioners and cardiologist is given by Home Care Telemedicine. CONCLUSION: Home Care Telemedicine offers a new possibility to improve ambulatory care of patients with chronic cardiac diseases and to support the health systems, especially the patients themselves and the physicians caring for them.