Telemedicine Patient Management Increases Life Expectancy

Telemedical interventional management reduces hospitalizations and prolongs the life of patients with heart failure (HF), according to a new study.

Researchers at Charité University Medicine (Charité; Berlin, Germany), University Hospital Würzburg (Germany), and other institutions throughout Germany conducted a prospective, controlled, randomized study to investigate the efficacy of a telemedical interventional management program in 1,538 patients with a left ventricular ejection fraction (LVEF) of 45% or lower. Half of the patients received a remote management intervention in addition to usual care; the other half received usual care only. The primary outcome was unplanned cardiovascular hospital admissions or all-cause death.

Patients in the remote management group received an electrocardiogram (ECG) monitoring unit with finger clip to measure oxygen saturation; a blood pressure monitor; scales to measure body weight; and a tablet computer to record self-reported health status data. Using the tablet computer, all patient data were transferred automatically to Charité's Telemedical Centre, where a team of doctors and nurses was available to continuously review the transmitted data and initiated specific measures, such as changing the patient's medication, recommending an outpatient visit, or inpatient treatment.

The results revealed that patients in the telemedical intervention group lost significantly fewer days due to unplanned hospitalizations for cardiovascular reasons than patients in the control group (17.8 versus 24.2 days, respectively). All-cause mortality for patients assigned to remote patient management was also significantly lower; over the course of a year, the death rate among patients in the usual care group was approximately 11.3 per 100 person-years, compared to 7.8 per 100 person-years in the telemedical group. The study was published on August 25, 2018, in The Lancet.

“The trial was able to show that the use of telemedicine can increase life expectancy; this finding applied irrespective of whether patients lived in rural areas with inadequate health care infrastructure, or in metropolitan areas,” said senior author Professor Friedrich Koehler, MD, of Charité. “This means that, in addition to improving the overall quality of health care provision, telemedicine is suitable for use as a compensatory strategy to offset regional differences in health care provision between rural and urban areas.”

Telemedicine is essentially a product of 20th century telecommunication and information technologies that permit communications between patient and medical staff with both convenience and fidelity, as well as the transmission of medical, imaging, and health informatics data from one site to another. It is most often used to improve patient, doctor, and nursing staff access to medical services in distant or sparsely populated rural communities.

Related Links:
Charité University Medicine
University Hospital Würzburg