Continuum of Care: Positioning of the Virtual Hospital.

Anne Catherine M H Van Der Lande,Roderick W Treskes,Saskia L M A Beeres,Martin J Schalij

doi:10.3389/fcvm.2021.779075

Anne Catherine M H Van Der Lande, Roderick W Treskes + Show 2 more

Open Access

https://doi.org/10.3389/fcvm.2021.779075

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Abstract

IntroductionPatients with multiple chronic diseases suffer from reduced life expectancy. Care for these patients is often divided over multiple healthcare professionals. eHealth might help to integrate care for these patients and create a continuum. It is the primary purpose of this paper to describe an intervention that integrates first, second, and third line care in patients with multiple chronic conditions using remote monitoring, remote therapy and data automatization, all integrated in a virtual care center (VCC).MethodsPatients diagnosed with three or more chronic conditions are included and given smartphone compatible devices for remote monitoring and a tablet for video consultations. Patients will be followed-up by the VCC, consisting of nurses who will coordinate care, supervised by general practitioners and medical specialists. Data is reviewed on a daily basis and patients are contacted on a weekly basis. Review of data is automated by computer algorithms. Patients are contacted in case of outcome abnormalities in the data. Patients can contact the VCC at any time. Follow-up of the study is 1 year.ResultsThe primary outcome of this study is the median number of nights admitted to the hospital per patient compared to the hospitalization data 12 months before enrolment. Secondary outcomes include all-cause mortality, event free survival, quality of life and satisfaction with technology and care.ConclusionThis study presents the concept of a VCC that integrates first, second, and third line care into a virtual ward using remote monitoring and video consultation.

Highlights

Patients with multiple chronic diseases suffer from reduced life expectancy
This case illustrates that scattering of medical information, multiple doctors in different hospitals and multimorbidity with polypharmacy can jeopardize a patient’s health. It illustrates the discomfort a patient might experience of having to be physically present at the outpatient clinic or day care clinic multiple times at different locations. It is the primary purpose of this paper to describe the rationale and design of an interventional single arm trial with historical comparison to evaluate the effect of integrating first, second, and third line care in patients with multiple chronic conditions using remote monitoring, remote therapy and data automatization, all integrated in a virtual care center (VCC)
Patients diagnosed with three or more of the following conditions are considered eligible for inclusion: diabetes mellitus, myocardial infarction, stroke, peripheral arterial disease, hypertension, dementia, heart failure, coronary artery disease, and/or chronic obstructive pulmonary disease

Summary

Introduction

Patients with multiple chronic diseases suffer from reduced life expectancy. Care for these patients is often divided over multiple healthcare professionals. EHealth might help to integrate care for these patients and create a continuum. It is the primary purpose of this paper to describe an intervention that integrates first, second, and third line care in patients with multiple chronic conditions using remote monitoring, remote therapy and data automatization, all integrated in a virtual care center (VCC). The growing number of patients with multiple chronic diseases is a challenge for healthcare professionals, insurers, and healthcare systems in countries across the globe. Research has shown that clinical outcome worsens with each additional chronic

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Conclusion