A Cross-Sectoral Telemedicine Network (sekTOR-HF) for Patients with Heart Failure

Objectives: Heart failure is associated with frequent hospital admissions and high mortality. Digital medical technologies could help to improve information exchange between healthcare providers and patients to prevent recurrent cardiac decompensation. Methods: Eligible patients aged between 18 and 85 (mean age 65 ± 12; 35.4% female) with symptomatic heart failure were included in this cross-sectoral telemedicine network (sekTOR-HF) study (n = 79) with a 12-month intervention period. Depending on the severity of heart failure at the time of inclusion, patients in the intervention group were labeled either as inpatients (NYHA III-IV) or outpatients (NYHA I-II). All patients not included served as the control group. Nearest Neighbor Propensity Score Matching was performed to obtain a control group of the same size. Patients in the intervention group received an electronic patient record with all relevant health data in an eHealth portal and the option to use learning modules. A coordinating network office supported all patients in the intervention group. Monitoring included patient self-measurement of blood pressure, weight, heart rate, and oxygen saturation and a digital electrocardiogram. The primary endpoint was all-cause rehospitalization in both groups. Results: The cumulative incidence for all-cause rehospitalization was lower in the intervention group compared to the control group (sHR 1.86; 95% CI: 1.12-3.09). There was no difference in all-cause mortality (HR 1.5; 95% CI: 0.53-4.21). Conclusions: Intervention management in this cross-sectoral telemedicine network led to a lower cumulative incidence of all-cause rehospitalization even in the early phase of intervention.