Abstract 20129: Iterative Review and Improvement of Automated HF Remote Monitoring System Increases Safety and Accuracy
Admission and readmission to the hospital for heart failure exacerbations are two of the highest cost services for Medicare. Multiple methods to decrease the risk of heart failure admission for exacerbations have been proposed For this study, we sought to determine if the Heart Failure Automated Remote Monitoring System (HF-ARMS) is capable of collecting data comparable to traditional telephonic human monitoring methods. One hundred one English speaking patients with heart failure were recruited from a single center to determine the safety of HF-ARMS, defined as clinical concordance between HF data collected by the HF-ARMS to data collected by a Human Researcher. Data successfully collected by both methods were analyzed and categorized as matches or various degrees of clinical discrepancy using coding schemes inclusive of all possible response combinations. Discrepancies were analyzed by a comparison of HF-ARMS collected data to human monitoring data and assigned a clinical significance value of no, minor, moderate or major. There were 577 matched calls with 33,524 individual data points. Over the entire study 93% of data collected by the HF-ARMS was equivalent (matched or no clinically significant difference) to data collected by human monitoring. Three percent of data had minor clinical discrepancies, 2% moderate discrepancies and 2% major discrepancies. The HF-ARMS and human monitoring under-triaged patients at approximately the same rate (3.81% vs. 3.69%). Two questions produced low match rates initially. A question about blood pressure initially had a match rate of 65%, which increased to 83% after a change in the methodology. A question about activity level was also changed with match rate improvement from 63% to 85%. By the end of the study, there was an increase of 18.7% in match rate, with 14.2% attributable to the implementation of the changes in these two questions. Study participants with higher levels of education and technology use had greater interaction ability with the HF-ARMS. HF-ARMS appears to be a safe and accepted method for remote monitoring. Validation of remote heart failure monitoring systems is necessary to demonstrate safety and efficacy.
- © 2010 by American Heart Association, Inc.