Heart patients who have implantable devices such as pacemakers, defibrillators, and loop recorders now have the hi-tech ability to send transmissions remotely to healthcare personnel in charge of keeping tabs on whether all is well. Sounds wonderful, but in practice many patients are failing to stick with transmission schedules. As a result, a plan that was meant to save both lives and money probably isn't doing either.
That's the not-so-good news from a study done by Edmond M. Cronin, MD of the Cleveland Clinic and colleagues and published online in HeartRhythm. "Expanding indications for cardiovascular implantable electronic devices are accompanied by an increasing burden of device clinic follow-up," the researchers wrote. "Non-actionable transmissions are rapidly processed, allowing clinicians to focus on clinically important findings. However poor patient compliance complicates workflow efficiency of currently available systems."
The team reported that 49.2% of patients missed their scheduled transmissions and that this resulted in an average of nearly an hour a day spent on telephone follow-up with those patients. According to MedPage Today, Cronin and colleagues were surprised by the high rate of missed scheduled remote transmissions. "We believe this is the first report of the magnitude of this problem in an unselected device clinic population," they wrote.
The team concluded that "once a patient is enrolled in remote monitoring, it does not guarantee their engagement with it." The upshot is that "clinically important patient or device events may remain undetected for a considerable time between interrogations."
The study's findings may not be applicable to other centers with a different mix of remote monitoring systems, as well as a different mix of devices, the researchers noted. Even so, this study should serve as a reminder to anyone with an implantable device to stick with the transmission schedule!