Nursing Presentation

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Home-Monitoring for CHF Patients

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Abstract

Home-telemonitoring entails the use of technology in disease management. Incorporating home-telemonitoring in the management of heart failure helps in improving the quality of life, ensuring effectiveness in the health care system while reducing incurred costs due to lowered hospitalization rates. Regardless of the system, medical practitioners play a pivotal role in the health outcome of a heart failure patient. The current systems involve the patients more, compared to the past noninvasive systems. Awaiting advancements in telemedicine may result in the linking of the systems with the patients’ electronic health records. Such an invention may result in data privacy issues.

Home-Monitoring for CHF Patients

Introduction

Complexities and fatalities associated with chronic disease necessitated the development of measures that reduce readmission rates and lower the number of times a patient needs to visit a doctor’s office. Self-monitoring has been the base of all the devised interventions geared towards the improvement of health outcomes. Self-monitoring entails the involvement of the patient in disease management. As such, the patient can undertake activities such as monitoring vital signs, adjusting lifestyle and medication, and adopting help-seeking behavior. Home-telemonitoring is more of self-monitoring that is taken a notch higher. The intervention entails the reliance of the information technology to relay data on a patient’s health status and enable a medical practitioner to monitor their patient’s health from afar. Home telemonitoring has opened avenues for disease management while ensuring that a patient receives health care assistance at the comfort of their home. It is also effortless to note an escalation in a patient’s condition while taking precautionary measures that end up saving a patient’s life.

Review of the Literature

Most health systems desire to improve the quality of life and the reduced burden of diseases. As such, medical researchers are continuously developing measures to improve the health status of chronic disease patients while lowering the pressure felt by the health care and economic system due to the large numbers of people with chronic illnesses. Rahimi et al. (2015) outlined the innovative models using digital technologies as helping bridge the existing gap in the health care system while also enabling efficiency and sustainability in heart failure care. The author noted that such models improve the remittance of evidence-based care while increasing the personalization of health care by offering patients a possibility of preferences. The currently improved home monitoring systems are developments of past systems. According to the authors, the past cohort of the non-invasive home monitoring systems insufficiently involved users through technology, hence the low adoption rates. Despite the success rates associated with home-telemonitoring systems, they require adequate preparation and participation of the patient and the health care system in question.

Kohn et al. (2017) observed that the first step of the development of a home telemonitoring system is the identification of patients in the initial decomposition course. By doing so, it is possible to reduce hospitalization rates. The authors noted that with the growing population of aged individuals, the number of chronic illnesses is bound to increase significantly, necessitating the development of strategies for chronic disease management. The social environment is slowly changing, with many parents living far from their children who would monitor their health. Most health care costs associated with the hospitalization of chronic disease patients could be avoided with the development and effectiveness associated with home-monitoring technologies. In addition to cost savings, effectiveness is another attribute associated with telemonitoring.

Boriani et al. (2016) outlined the results from different studies, denoting the reduced resource use and costs associated with remote monitoring. There is a reduction in staff time that would be utilized during the random visits to the hospitals and re-hospitalization. According to the authors, heart failure patients often visit doctors’ appointments accompanied by relatives or caregivers. As such, they have to incur traveling expenses, among other miscellaneous expenses. These costs are eliminated when a patient is enlisted in a telemonitoring program. Eurlings et al. (2018) added that despite the limitation on data on the cost-effectiveness of telemedicine, the inclusion of the patients in self-management provides a potential in the reduction of the health care costs associated with chronic diseases. The authors cited the example of the cardioMEMS device associated with an approximate $13,979 in each acquired quality-adjusted life. According to Klersy et al., as cited by Eurlings et al. (2018), the cardiac devices ensure a 44% reduction in the hospital visits without interference on mortality and a 15-20% cost saving. In a quick rejoinder, Eurlings et al. (2018) highlighted the lack of clarity in the cost-effectiveness associated with non-invasive telemonitoring.

The remote monitoring technologies’ effectiveness is not just about cost savings but also about the prompt relay of a patient’s information compared to the traditional hospital visits. Cowie et al. (2016) discussed the cardioMEMS device slightly different from earlier telemonitoring technologies. For this device, it ranks as the first system to ensure real-time remote monitoring with the aim being the maintenance of the pressure within the required therapeutic threshold, while alternating the medications depending on the pressure changes. The authors voiced that earlier non-invasive technologies relied on metrics such as weight, blood pressure, and heart rate. Any changes in the highlighted would prompt communications with physicians through telephone calls or data links. The advantages of the telemonitoring stretch beyond the health care services within the boundaries of a particular country.

Charrier et al. (2016) highlighted telemonitoring as enabling patients to access rare expertise. A patient may not be experiencing remarkable health outcomes due to the inability to access specialized care. However, through…