P431 "TELECUORE": EXPERIMENTAL PILOT PROJECT FOR THE INTEGRATED MANAGEMENT OF 250 PATIENTS WITH CHRONIC HEART FAILURE THROUGH THE USE OF TELEMEDICINE IN PIACENZA AUSL

Abstract

Abstract Background Heart failure (HF) has an high social–health impact that requires frequent checks and urgent hospital visits. The management of chronicity through telemedicine, integration of hospital–territory care and multidisciplinarity represents a goal of the italian PNRR. Objectives The project tests the feasibility of an organizational model of integrated management of heart–failure patients based on multidisciplinary integration and the use of telemedicine. Materials and Methods 250 heart failure patients will be selected by the Heart Failure Outpatient Department of AUSL Piacenza, with the following characteristics: positive technological anamnesis, NYHA functional class II–III, clinical instability (hospital access for heart failure/need to boost diuretics in the previous 12 months) and management complexity. We will use Aditech devices, which through mobile–app will send the following parameters to the platform on a daily basis: blood pressure, weight, ECG (single track) and saturation. A QoL Assessment Questionnaire (KCCQ) will be administered. 10 GPs will be selected to view the data on the platform and be able to carry out a cardiological Teleconsultation. The Case manager (CM) and a cardiovascular technician (TFCPC) will explain the functioning of the device to groups of 2–3 patients and, in collaboration with the nursing staff, the baseline control of the parameters and blood tests will be carried out. Pre–set alerts will be activated based on the changes in the detected parameters, which will be evaluated by the TFCPC/CM and managed with the Cardiologist for therapy optimization and patient empowerment. Through televisit, the CM will evaluate the case, based on pre–established protocols, will program the necessary diagnostic services (EGC, chest echo/fast echo, performed by the TFCPC using wireless echo probes at community homes) and will plan ways to improve lifestyle. The intervention of the GP or cardiologist will be scheduled after a multidisciplinary briefing based on the clinical case. Conclusions The project experiments an integrated hospital–territory service model for the heart failure patient, through the use of telemedicine. The home management of the instrumental parameters and their daily sending should help to quickly manage any problems. Televisit integrated with telemonitoring and teleconsultation should reduce the number of hospital admissions.