Health Matters - London Bridge Hospital

Remote Home MonitoringRemote HomeMonitoring Serviceat London BridgeHospitalHow does thepatient benefit?• Remote follow-up providesvaluable clinical informationthat cannot normally beobtained until the nextscheduled clinic visit• It can potentially reduceinappropriate therapy• Earlier pharmacologicalintervention• Increased peace of mindand the assurance thattheir Consultant and GPcan monitor specifi c deviceinformation continuously• Individually tailoredcomprehensive cardiac care,promoting early detection,notifi cation and interventionof any potential cardiacdevice related problemsRemote monitoring has recentlybeen introduced to the CardiologyDepartment at London Bridge Hospitalwith great success. Home monitoringis a fairly new initiative introduced forpatients with implantable devices, such asa pacemaker or defi brillator. It providesa unique way to collect and downloaddiagnostic data from an implantabledevice while the patient remains in thecomfort of their own home. This enablesthe physician and GP to obtain nearlythe same information as a hospital clinicvisit, with just a few exceptions.So how does it work?The system is able to function with asmall piece of equipment, roughly thesize of a home telephone. All the patientneeds is a power cord and telephonelandline to connect. The patients aregiven a full demonstration and educationsession in the clinic before taking thecommunicator home. The device sits in aconvenient place in the home, usually ona bedside table and is able to downloaddevice information and send it securelyvia the internet. This information is thenaccessed by a Cardiac Pacing Physiologistwho interprets the results and producesa report for the Consultant.How often is informationdownloaded?The frequency of the informationdownloads is decided by the Consultantdepending on the nature of the patient’sdevice and medical history. For example,a pacemaker patient is usually seen inclinic once a year. With home monitoringa Consultant may decide they would likea download once every three monthsfor a periodic update. These scheduleddownloads provide the opportunityfor earlier detection, notifi cationand intervention of signifi cantevents between scheduled Physicianappointments, thus offering a greaterlevel of comprehensive cardiac care.What information does RemoteHome Monitoring provide?In addition to the scheduled downloads,there is also an alert system. The alertsystem can be extremely useful in thecase of new onset atrial fi brillation. Apatient with a pacemaker or defi brillatormay suddenly develop atrial fi brillation ora patient known to have atrial fi brillationmay have an episode for over 24 hourswithout being aware of it.With the alert system we are notifiedof the event, possibly before the patientbegins to suffer any symptoms.A medication change can then beachieved by a GP follow-up almostimmediately after the identifi cationof arrhythmia, thus saving a trip tothe Consultant in hospital. Allowingfor an early detection can be veryadvantageous for a patient’s wellbeing.Another scenario occurs when apatient with a defi brillator receivesa shock. If the patient is at home anemail, text, fax or phone call is theninitiated to the clinic to inform us ofthe event. The Cardiac Physiologist canthen access the event information anytime of day via the secure website andthen speak with the Physician aboutthis event. Obtaining this informationin such a timely manner can be vitalto decide if the patient needs to go tohospital, have a medication change orin some very rare cases, sees that theshock may have been inappropriateand therefore needn’t worry. By nomeans is it an emergency serviceand the patient is aware of this whenthey give permission to enrol in theprogramme, however, it provides vitalinformation and the opportunity toact before the next scheduledPhysician appointment.TWELVERemote Home Monitoring