Journal of Telemedicine and Telecare > Volume 14, Number 4 > Pp. 178-181

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RESEARCH Original articles

Utilization of telemedicine by heart disease patients following hospitalization

Andreas J Morguet , Paul Kühnelt, Antje Kallel, Ursula Rauch and Heinz-Peter Schultheiss

Department of Cardiology and Pulmonology, Charité – Campus Benjamin Franklin, Berlin, Germany

Correspondence: Dr Andreas J Morguet, Department of Cardiology and Pulmonology, Charité – Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany (Fax: +49 30 8445 4648; Email: amorguet{at}zedat.fu-berlin.de)

NYHA class III and IV chronic heart failure has been established as a potential indication for telemedical care and monitoring already. We conducted a prospective study to assess the utilization of telemedical services by cardiac patients in order to identify further indications. A total of 540 patients (mean age 59 years) with various heart diseases participated for at least 30 days in a home-based telemedicine service programme. The two primary outcome measures were the rates of symptom-driven telephone calls (A) and ECG transmissions (B) per patient-year. The total follow-up was 68,649 days, with a median of 93 days. Symptomatic patients placed 713 calls and transmitted 221 ECGs. Poisson regression analysis with subset selection yielded four significant (P < 0.05) independent positive predictors of the use of the telemedicine service: (1) recent repeat (at least one previous) percutaneous coronary intervention (A, P = 0.010; B, P = 0.001); (2) recent cardioversion for atrial fibrillation or flutter (A, P < 0.0001; B, P < 0.0001); (3) ejection fraction (A, P = 0.012; B, P > 0.05); and (4) reciprocal of age (A, P < 0.0001; B, P > 0.05). These data suggest that telemedicine may benefit patients following repeat percutaneous coronary intervention or cardioversion for atrial fibrillation. Since patients availed themselves of telemedicine service less with deteriorating ejection fraction and increasing age, individuals with chronic heart failure will need dedicated programmes, especially when they are older.

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