B-PO03-188 RESOURCE IMPLICATIONS AND CLINICAL UTILITY OF A NOVEL CARDIAC IMPLANTABLE ELECTRONIC DEVICE (CIED)-DIGITAL CARE PATHWAY (TRIAGE-HF PLUS) TO REMOTELY MONITOR AND MANAGE A HEART FAILURE (HF) POPULATION

Abstract

New approaches are needed for remote management of HF patients. To characterize clinical workflow, resource use and utility of the CIED-based ‘Triage-HF Plus’ (T-HF+) remote monitoring HF pathway. T-HF+ is a prospective, real-world evaluation of 415 patients with compatible Medtronic ICD or CRT devices. The Triage-HF algorithm (using up to 9 device-monitored parameters) classifies patients as low/medium/high risk of HF hospitalization in the next 30-days. In the T-HF+ pathway, a ‘high’ risk status prompts phone assessment for HF and non-HF acute issues. Remote guideline-directed interventions are based on clinical assessment. Over 15-months, 159 T-HF+ assessments were triggered for 102 patients, with successful contact in 148 (93%) cases (median time to contact 3 days, median call length 10 mins) (Table 1). 70/148 (47%) contacts identified an acute medical issue; worsening HF in 47 (32%), non-HF issue in 33 (22%). Interventions were performed in 44 (63% of acute issues). For those without acute medical issue (n=78), 13 (17%) reported recent hospitalization or intervention. 110/148 (77%) had 30-day follow-up telephone assessment (median call length 9 mins). 30-day risk status was medium/low in 81 8%. 24/30 (80%) cases with an acute medical issue and intervention indicated patient reported improvements at 30-days. In 5 cases the patient was hospitalized within 30 days of initial assessment. Average weekly workload to manage the population (n=415) was 96.4 minutes. T-HF+ pathway is a high-tech, low labour digital care pathway which promotes HF disease stability and symptom optimisation for patients with CIEDs.