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Updated: May 19, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
A randomised trial of a remote home support programme for infants with major congenital heart disease
Brian McCrossan1, Gareth Morgan, Brian Grant
1Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, UK. brianmccrossan@doctors.org.uk
Insights
Tele-homecare using video-conferencing significantly improves clinician confidence and parental satisfaction for infants with congenital heart disease (CHD). This approach reduces healthcare resource use and costs compared to telephone support.
Area of Science:
- Pediatric Cardiology
- Digital Health
- Healthcare Management
Background:
- Major congenital heart disease (CHD) requires ongoing monitoring and support for infants and their families.
- Traditional homecare models can be resource-intensive and may present logistical challenges.
Purpose of the Study:
- To evaluate the sustainability, clinical utility, and acceptability of a tele-homecare program for infants with major CHD.
- To assess the impact of tele-homecare on healthcare resource utilization.
Main Methods:
- A randomized controlled trial involving 83 infants with major CHD.
- Participants were assigned to video-conferencing support, telephone support, or a control group.
- Remote consultations were conducted regularly, with video-conferences utilizing digital network lines and later broadband connections.
Main Results:
- Clinicians reported higher confidence in medical decision-making with video-conferencing compared to telephone support (p=0.01).
- Parents showed significantly higher satisfaction with video-conferencing support (p=0.001).
- The video-conferencing group experienced a 37% reduction in healthcare resource use and lower hospitalization risk (p<0.001, p=0.006 respectively), with significantly lower direct health service costs (p<0.05).
Conclusions:
- Tele-medicine home support programs are feasible, sustainable, and effective for families of infants with major CHD.
- Video-conferencing based home support is superior to telephone consultations, leading to high parental satisfaction.
- Tele-homecare significantly reduces health service utilization and holds potential for cost reduction.
Objectives:
To assess the sustainability, clinical utility and acceptability to clinicians and parents of a tele-homecare programme for infants with major congenital heart disease (CHD), and to evaluate the impact on healthcare resource use.
Design:
Randomised control trial.
Setting:
UK tertiary congenital cardiac centre.
Participants:
83 infants with major CHD.
Intervention:
Participants were randomised to one of three groups: video-conferencing support (n=35), telephone support (n=24) and a control group (n=24). Patients in the two intervention groups received regular, standardised remote consultations. Video-conferences (VCs) were facilitated by Integrated Systems Digital Network lines and replaced by home broadband connections later in the study.
Main Outcome Measures:
Healthcare resource use, utilisation including hospitalisation, clinicians' opinions on utility and quality of interventions, parental opinions on quality of interventions.
Results:
Clinicians were more confident making medical decisions following VCs compared with telephone consultations (p=0.01). Both VC and telephone support were very well received, but parents expressed significantly higher levels of satisfaction with VC support (p=0.001). Healthcare resource use was 37% lower in the video-conferencing group compared with both telephone support and control groups (p<0.001), as was the risk of hospitalisation (p=0.006). Direct health service costs were significantly lower in the video-conferencing group (p<0.05).
Conclusions:
A tele-medicine home support programme for families of infants with major CHD is feasible, sustainable and effective. Home support with video-conferencing is superior to telephone consultations. Parents are highly satisfied with tele-homecare. Tele-homecare significantly reduces health service utilisation and may reduce health service costs.