P0478 / #1183: IMPROVING CARE OF CHILDREN WITH COMPLEX CONGENITAL HEART DISEASES WITH HOME MONITORING AND EDUCATION PROGRAM, ¡COLOMBIAN STYLE!

Abstract

Aims & Objectives: Palliated congenital heart disease, especially Hypoplastic Left Heart Syndrome (HLHS) during Interstage are in a high-risk period of morbidity/mortality. Home monitoring programs effectively improved outcomes in developed countries. With similar considerations an adapted home monitoring program (PROMESA project) was developed in our institution. Methods: A virtual-face mixed model program. Caregivers are provided with cellphone with a specific app, oximeter, scale, all of them received training and education. Follow-up is performed with audio/video calls and regular cardiology checkups. Monitoring data are reviewed in a control center. Continuous education reinforcements are done at every contact with caregivers and through social networks/website. Results: From January 2019 to January 2020, 44 patients were pre-selected. 3(6,8%) died before first procedure, 24(54,5%) were excluded (inoperable, without mobile signal coverage, no defined caregiver, unsuccessful completion of training). 17(38,6%) children received first procedure, four of them are in post-operatory period. Thirteen were discharged with home monitoring. Six are under follow-up and six were successfully transitioned to the second stage procedure. One requested withdrawal. The program has done 693 follow-up calls, 291 video-calls and allowed the identification of 1345 alarms, which led to audio/Video calls contacts and informative, educational or clinical recommendations. Eight critical situations were identified that prompted emergency consultation and lead to in-hospital management including hemodynamic procedures. Conclusions: Project PROMESA is a home monitoring program adapted for Colombia’s needs, mainly structured with telecommunication technologies, strong education and close virtual/face follow-up that could improve outcomes in this population.