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Published on: December 11, 2019
Improving care for patients with atrial fibrillation through the use of a personal electrocardiogram
Teresa Praus1, Jonathan Li1, Svetlana Barbarash1
1Department of Cardiology, Southwest Medical, Part of OptumCare Las Vegas, Nevada.
Insights
A KardiaMobile device program for atrial fibrillation (AF) management improved patient access and reduced anxiety. This patient-centered approach demonstrated cost-effectiveness by decreasing emergency department visits.
Area of Science:
- Cardiology
- Digital Health
- Health Economics
Background:
- Atrial fibrillation (AF) is a prevalent arrhythmia impacting over six million individuals in the U.S.
- The annual economic burden of AF exceeds $6 billion, with acute events escalating costs.
- Symptomatic AF patients often seek costly and anxiety-inducing acute care.
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of a remote AF management program using a personal ECG device.
- To assess the impact of improved access to cardiology providers on patient outcomes and resource utilization.
- To determine if a patient-centered approach can reduce emergency department (ED) and urgent care (UC) visits.
Main Methods:
- A convenience sample of 43 patients with a history of AF-related ED/UC visits or requiring AF management were enrolled.
- Patients used KardiaMobile devices to transmit daily ECG recordings and symptom-triggered data.
- Recordings were reviewed by a nurse practitioner (NP), with follow-up via phone, telehealth, or in-person visits.
Main Results:
- 97% of participants found value in the program and device, with 97% reporting improved access to care.
- 86% of patients experienced decreased anxiety.
- 34% of participants would have visited an ED and 25% an UC without the program, saving $81,950 in ED costs alone.
Conclusions:
- Personal ECG devices with NP oversight offer a cost-effective strategy for managing AF.
- This approach reduces unnecessary healthcare resource utilization.
- The program is patient-centered, enhances access, and empowers patients in managing their AF symptoms.
Background:
Atrial fibrillation (AF) is the most common arrhythmia affecting more than six million people in the United States. The economic burden is estimated to be >$6 billion annually with catastrophic events dramatically increasing expenditure. When patients experience symptoms, they commonly present to an acute care facility; this can be costly and anxiety provoking.
Local Problem:
Same-day access issues prohibit patients from communicating directly with their cardiology provider, forcing them to use resources and increasing psychological burden.
Methods:
A convenience sample, made up of 43 patients, was given a KardiaMobile device. Eligible patients had ≥2 AF-related emergency department (ED) or urgent care (UC) visits over 12 months, needed rate control with medication titration, or were monitored for AF reoccurrence after reestablishing sinus rhythm.
Interventions:
Patients emailed recordings daily and when experiencing symptoms. The recordings were reviewed by a nurse practitioner (NP); abnormal readings were followed by a phone call, telehealth, or in-person visit.
Results:
An independently designed survey was conducted online; almost all respondents (97%) found value in the project and the device. Virtually all respondents (97%) felt that the program improved access. A majority (86%) reported decreased anxiety. Had the respondents not been in the program, 34% indicated that they would have presented to an ED and 25% would have presented to an UC, realizing a cost savings of $81,950 in reduced ED visits alone.
Conclusion:
A personal electrocardiogram, with NP oversight, to manage AF is cost-effective and reduces unnecessary resource utilization. It is patient centered, improves access, and empowers patients to manage their symptoms.
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