植入式心脏设备工作流程的重新设计提高了远程监测的及时性和心力衰竭警报指标。
Redesign of Implantable Cardiac Device Workflow Improves Remote Monitoring Timeliness and Heart Failure Alert Metrics.
作者信息
Stolen Craig M, Kupfer Molly E, Tomes Karen, Horan Sean, Pandey Ananta, Snodie Julie, Frost Kate, Merhaut Shawn
机构信息
Cardiac Rhythm Management division of Boston Scientific Corporation, St. Paul, MN, 55112, USA.
出版信息
J Cardiovasc Transl Res. 2025 Jun 6. doi: 10.1007/s12265-025-10632-z.
Integration into clinical workflow remains a barrier to realizing the benefits of remote heart failure monitoring technologies. A workflow redesign program was conducted at 27 cardiology sites to improve implementation of heart failure remote monitoring with HeartLogic. Device data was retrospectively retrieved from HeartLogic-capable ICDs and CRT-Ds for the 12-month periods before and after re-design. Workflow redesign led to a decrease in HeartLogic enablement time (28±110 to 10±31 days, p<0.0001) and reduction in delayed data transmissions (10% to 6%). The number of HeartLogic alert onsets per year was unchanged; however, the length of individual alerts decreased from pre- to post-redesign (47.6±38.4 to 44.1±36.5 days, p=0.001) as did the percentage of time patients spent in alert (15.5±19.9% to 14.3±19.0%, p=0.04). The maximum HeartLogic index values per alert were also lower post-redesign (28.9±12.8 vs 27.8±12.1, p=0.001). Workflow redesign improved remote monitoring utilization and heart failure alert metrics.
融入临床工作流程仍然是实现远程心力衰竭监测技术益处的一个障碍。在27个心脏病学站点开展了一项工作流程重新设计计划，以改善使用HeartLogic进行心力衰竭远程监测的实施情况。从具备HeartLogic功能的植入式心律转复除颤器（ICD）和心脏再同步治疗除颤器（CRT-D）中回顾性获取重新设计前后12个月期间的设备数据。工作流程重新设计导致HeartLogic启用时间减少（从28±110天降至10±31天，p<0.0001），延迟数据传输减少（从10%降至6%）。每年HeartLogic警报发作的次数没有变化；然而，从重新设计前到重新设计后，单个警报的时长缩短了（从47.6±38.4天降至44.1±36.5天，p=0.001），患者处于警报状态的时间百分比也降低了（从15.5±19.9%降至14.3±19.0%，p=0.04）。重新设计后每个警报的最大HeartLogic指数值也更低（28.9±12.8对27.8±12.1，p=0.001）。工作流程重新设计改善了远程监测的利用率和心力衰竭警报指标。
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