Collaboration among general cardiologists, heart failure specialists, and electrophysiologists: what are the barriers?

Although ongoing research has focused on the reliability and accuracy of data derived from implanted devices, important challenges remain, among which is the development of a framework for handling the data, including delineation of responsibility for interpretation and management of the data. The barriers to a successful device-monitoring program include difficulties in data access, unfamiliarity with a new treatment approach, lack of sufficient knowledge and experience in data interpretation, and difficulty incorporating the program into the existing workflow. The dynamics of collaboration between heart failure and electrophysiology (EP) specialists may differ locally and regionally, but a common set of barriers resulting from traditional models of care constrains incorporation of device-based data into clinical practice. Active dialogue between EP and heart failure specialists that involves the sharing of experiences and practice models is an important first step to overcoming these barriers. In the future, a "virtual clinic" model of patient care can only be realized with the successful incorporation of remotely accessed device data.