Reducing heart failure patients from hospitalisation using remote heart alert system

Heart failure is a debilitating condition that impacts the lives of nearly one million people in the UK. For the majority of patients with heart failure there is no cure, with treatments focussing on stabilising the condition and managing symptoms.

In collaboration with Medtronic, researchers at Manchester University NHS Foundation Trust (MFT) and The University of Manchester developed a new remote monitoring pathway, called ‘TriageHF Plus’, that acts like a risk detection tool and takes advantage of the health data routinely collected by pacemakers and implantable cardioverter defibrillators (ICDs).

Many patients with severe heart failure are fitted with a heart monitoring device that detects and treats dangerous, irregular heart rhythms. The information – including heart rate, heart rhythm, physical activity, and fluid build-up in the lungs – is automatically streamed to the hospital from the patient’s home.

The remote alert system notifies healthcare professionals when a person’s condition becomes ‘high risk’ of them being hospitalised within 30 days, prompting a phone consultation to assess their condition.  Where a secondary intervention is needed, the Heart Failure Nurse might change the patient’s medication, advise lifestyle changes, escalate their heart failure appointment, or call them in for more tests, all with the aim to reduce the risk of hospitalisation. For a small minority, they might refer them to their GP or the Emergency Department for further tests.

Supported by MFT’s Diagnostics and Technology Accelerator (DiTA), researchers recruited a total of 758 patients, the majority of whom had heart failure, from three hospitals across the trust who were already fitted with an ICD or pacemaker – 443 were monitored with the new TriageHF Plus alert system and 315 patients received standard care from their device.

Researchers found that the rate of hospitalisation was 58 per cent lower in patients whose devices were monitored by TriageHF Plus. In this group, the remote alert system issued a total of 196 ‘high risk’ alerts, which led to a phone call assessment in 182 patients.

Of the 182 phones calls, 79 (43 per cent) were confirmed to have an acute medical issue, from which 44 people received a secondary intervention.

The initial phone consultation took an average of just ten minutes, with an average nine-minute follow-up call 30 days later. The team in Manchester hopes that the remote alert system that requires minimal workforce resource will help to monitor patients with a cardiac device and heart failure across other hospitals in the UK.

The HealthTech Research Centre in Emergency and Acute Care will build on the success of MFT’s DiTA to ensure that state-of-the-art technologies and innovations are assisting our clinicians to diagnose diseases earlier and ensure appropriate treatments are provided sooner to our patients from Greater Manchester and beyond.