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Redesign of Implantable Cardiac Device Workflow Improves Remote Monitoring Timeliness and Heart Failure Alert Metrics
Craig M Stolen1, Molly E Kupfer2, Karen Tomes2
1Cardiac Rhythm Management division of Boston Scientific Corporation, St. Paul, MN, 55112, USA. craig.stolen@bsci.com.
Journal of Cardiovascular Translational Research
|June 6, 2025
Summary
Workflow redesign improved remote heart failure monitoring. This enhanced HeartLogic system implementation, reducing enablement time and improving alert metrics for better patient care.
Area of Science:
- Cardiology
- Medical Technology
- Health Informatics
Background:
- Remote monitoring for heart failure (HF) is beneficial but faces clinical workflow integration challenges.
- Effective implementation of HF remote monitoring technologies is crucial for patient outcomes.
Purpose of the Study:
- To assess the impact of a workflow redesign program on the implementation and effectiveness of remote HF monitoring using the HeartLogic system.
- To evaluate changes in device enablement time and alert metrics following workflow optimization.
Main Methods:
- A workflow redesign initiative was implemented across 27 cardiology sites.
- Retrospective analysis of device data from HeartLogic-enabled implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy-defibrillators (CRT-Ds) before and after redesign.
- Key metrics included enablement time, data transmission delays, alert onset frequency, alert duration, and alert index values.
Main Results:
- Workflow redesign significantly decreased HeartLogic enablement time (28±110 to 10±31 days, p<0.0001) and reduced delayed data transmissions (10% to 6%).
- While the number of alerts per year remained stable, individual alert duration decreased (47.6±38.4 to 44.1±36.5 days, p=0.001), as did the percentage of time patients spent in alert (15.5±19.9% to 14.3±19.0%, p=0.04).
- Maximum HeartLogic index values per alert were also lower post-redesign (28.9±12.8 vs 27.8±12.1, p=0.001).
Conclusions:
- Workflow redesign is effective in improving the integration and utilization of remote heart failure monitoring technologies.
- Optimized clinical workflows enhance the efficiency of remote monitoring systems like HeartLogic, leading to improved alert management and potentially better patient care.
- These findings support the adoption of workflow redesign to maximize the benefits of remote patient monitoring in cardiology.
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