Toscos Tammy, Daley Carly, Wagner Shauna, Coupe Amanda, Ahmed Ryan, Holden Richard J, Flanagan Mindy E, Pfafman Rachel, Ghahari Romisa Rohani, Mirro Michael
Parkview Mirro Center for Research and Innovation, Parkview Health, Fort Wayne, Indiana.
Department of BioHealth Informatics, IUPUI School of Informatics and Computing, Indianapolis Indiana.
Cardiovasc Digit Health J. 2020 Sep 19;1(2):97-106. doi: 10.1016/j.cvdhj.2020.09.003. eCollection 2020 Sep-Oct.
Heart failure (HF) is a growing public health problem in the United States. Implantable cardiac resynchronization therapy (CRT) devices reduce mortality and morbidity, and remote monitoring (RM) of these devices improves outcomes. However, patient RM adherence is low, due in part to lack of access to their RM data. Providing these data to patients may increase engagement, but they must be appropriately tailored to ensure understanding.
The purpose of this study was to examine patients' experiences interacting with their RM data through a novel digital dashboard as part of daily life.
In this mixed-methods pilot study, 10 patients with implantable CRT defibrillators were given access to a patient-centered RM data dashboard, updated daily for 6-12 months. Pre- and post-health literacy, engagement, electronic portal (MyChart, Epic Systems Corporation) logins, and RM adherence were measured; system usability scores were collected at exit; and dashboard views were tracked. Exit interviews were conducted to elucidate patients' experiences.
Participants (100% white; 60% male; age 34-80 years [mean ± SD: 62.0 ± 13.4]) had adequate health literacy, increased MyChart logins ( = .0463), and nonsignificant increase in RM adherence. Participants viewed their dashboards 0-42 times (mean 14.9 ± 12.5). Interviews revealed participants generally appreciated access to their data, understood it, and responded to changes; however, questions and concerns remained regarding data interpretation and visualization.
Preliminary findings support potential future integration of a CRT RM data dashboard in the daily care of HF patients. With appropriate informational support and personalization, sharing RM data with patients in a tailored dashboard may improve health engagement.
心力衰竭(HF)在美国是一个日益严重的公共卫生问题。植入式心脏再同步治疗(CRT)设备可降低死亡率和发病率,对这些设备进行远程监测(RM)可改善治疗效果。然而,患者对RM的依从性较低,部分原因是无法获取其RM数据。向患者提供这些数据可能会提高他们的参与度,但必须进行适当调整以确保他们能够理解。
本研究的目的是通过一个新颖的数字仪表盘来检查患者在日常生活中与他们的RM数据交互的体验。
在这项混合方法的试点研究中,10名植入CRT除颤器的患者可以访问一个以患者为中心的RM数据仪表盘,该仪表盘每天更新,持续6至12个月。测量了健康素养、参与度、电子门户(MyChart,Epic Systems Corporation)登录情况以及RM依从性的前后变化;在研究结束时收集系统可用性评分,并跟踪仪表盘的查看情况。进行了退出访谈以阐明患者的体验。
参与者(100%为白人;60%为男性;年龄34至80岁[平均±标准差:62.0±13.4])具有足够的健康素养,MyChart登录次数增加(P = 0.0463),RM依从性有不显著的增加。参与者查看仪表盘的次数为0至42次(平均14.9±12.5)。访谈显示,参与者总体上对能够获取自己的数据表示赞赏,理解这些数据,并对变化做出了反应;然而,在数据解释和可视化方面仍存在问题和担忧。
初步研究结果支持未来有可能将CRT RM数据仪表盘整合到HF患者的日常护理中。通过适当的信息支持和个性化设置,在定制的仪表盘中与患者共享RM数据可能会提高健康参与度。