Primary care providers (PCPs) are the backbone of the continuum of patient care.
Given the nature of healthcare today, providers need the right data, at the right time, to intervene in the right place. This concept is of critical importance when caring for a patient population at risk for Atrial Fibrillation (AFib) and the sequelae that can follow. According to the American Heart Association, “the prevalence of AFib in the United States was estimated to be 5.2 million in 2010, increasing to 12.1 million by 2030” and the top risk factors include essential hypertension, heart disease, and obesity(1), with the majority being managed by a primary care provider.
Recent studies have indicated that approximately 70% of AFib episodes are considered silent, or without symptoms, and can last up to 48 hours(2). Traditional cardiac monitors are initiated after a cardiac event and either place the onus of data sharing on the patient or come in the form of a continuous wearable device. What is missing from the remote patient monitoring (RPM) arsenal of equipment is a cardiac monitoring solution that not only provides ECG data but integrates seamlessly into existing workflows and provides a direct line of data to the provider.
Traditional Solutions: Screening the At-Risk Patient Population
Traditional non-invasive cardiac monitoring options include Holter and consumer-grade portable ECG device monitors. These options are often deployed when a patient experiences symptoms consistent with AFib. More recent app-based technologies have been introduced to the market and are patient-driven for self-monitoring to check heart health in between formal ECGs. Most of these devices require not only an expensive cellular device to run the application but require patients to use WiFi networks to send data.
Traditional options can hinder AFib detection and do not demonstrate the best practice approach of intentional screening.
With a mere 30% of AFib patients experiencing symptoms, a more refined approach is necessary for intentional monitoring to allow for early detection and treatment of patients. At times, a retrospective approach proves to be too late in prevention of long-term issues. In fact, studies indicate that 25% of patients who have had a stroke were not diagnosed with AFib until after the stroke(3). The right time to treat patients is closest to an AFib event and this requires a monitoring solution that removes the patient as the middleman and integrates directly into the provider’s existing workflows and care pathways.
A New Approach to Remote Cardiac Monitoring
Lohman Technologies offers a two-part remote cardiac monitoring solution:
The HomECG+ Solution:
This FDA-cleared, pocket-sized device allows patients to capture a medical grade ECG reading in less than a minute. A green-colored message of “AFIB NOT DETECTED” indicates an absence of AFib in that reading, while a red-colored message of “POSSIBLE AFIB DETECTED” notifies the patient that AFib was likely present. Utilizing cellular based technology embedded in the device itself, there is no need for a cell phone or app to complete the process. The ECG data is sent directly to the patient’s electronic health record (EHR) using the RPM platform. Providers can immediately review 40-second PDFs of ECG data, even those that did not elicit an alarm notification, to collect information on patient baseline rhythms and track trends of deviation.
Clinical Workflow Optimization:
The HomECG+ implementation team offers a best practice approach to introducing remote cardiac monitoring into a new site. Customized notification parameters can be set, and data is aggregated to one location allowing for the provider to make timely decisions about the patient’s care.
The newly designed workflow includes
1) Process Refinement
2) Policy & Procedure Modification
3) Technology Integration and
4) Clinical Documentation Standardization.
Improving the Continuum of Care with HomECG+
A remote cardiac monitoring device becomes true healthcare innovation when it provides data directly to the provider and proves to be an adjunct to the current clinical care pathway. This level of cardiac care offers a more patient-centered approach that mitigates risk for the provider and truly enhances the overall patient experience. A Care Memphis provider, and user of the HomeECG+, said, “We have many patients with essential hypertension and other risk factors for AFib. Managing these patients is difficult and ECG data has been a missing link in our chain of continuity. The HomECG+ filled that void and has changed the way we practice medicine for our patients.”(4)
Lohman Technologies: A Collaborative Partner
Lohman Technologies is the creator of the HomECG+ solution, an FDA-cleared, clinical grade remote monitoring solution for atrial fibrillation (AFib) detection. Lohman Technologies' mission is to continuously improve and impact the care continuum through innovative remote cardiac monitoring, collaborative partnerships, and the promotion of health equity. The HomECG+ patented mobile solution connects patient data directly with their healthcare providers without the need for a smartphone or WIFI technology. For more information about how Lohman Technologies is connecting patients, providers and peace-of-mind, visit www.homecg.com.
For more information about the HomECG+ solution, click here.
References:
Verani, S., Alonso, A., Aparicio, H., Benjamin, E., & Bittencourt, M. et. al. “Heart Disease and Stroke Statistics.” American Heart Association. vol. 143, no.8, 2021. doi: 10.1161/CIR.0000000000000950.
Reiffel, J. “When Silence Isn’t Golden: The Case of “Silent” Atrial Fibrillation.” The Journal of Innovations in Cardiac Rhythm Management. vol 8, no.11, 2017. doi: 10.19102/icrm.2017.081102.
Uitenbogaart, S., Verbiest-van Gurp, N., Lucassen, W., Winkens, B., & Nielen, M., et. al. “Opportunistic screening versus usual care for detection of atrial fibrillation in primary care: cluster randomised controlled trial.” British Medical Journal: BMJ. 16 September 2020. doi: https://doi.org/10.1136/bmj.m3208.
Foner, Melissa. Physician Assistant, Care Memphis Clinic. Personal Interview. 1 August 2021.