Dhruva Sanket S, Marunick Kurt, Moore Hans J, Rohrbach Gregory, Rotering Thomas L, Raitt Merritt H
Section of Cardiology, Department of Medicine, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA.
Cardiology Section, Medical Service, Washington, DC Veterans Affairs Medical Center, Washington, DC, USA.
Heart Rhythm O2. 2025 Apr 8;6(6):893-902. doi: 10.1016/j.hroo.2025.03.024. eCollection 2025 Jun.
Remote monitoring (RM) is central to care of patients with cardiovascular implantable electronic devices (CIEDs). However, because RM care presents a large and increasing clinician workload, solutions are needed to increase care efficiency. The Veterans Health Administration National Cardiac Device Surveillance Program (VHANCDSP) is a response to this need by centralizing RM processes, reviewing all RM transmissions, identifying patients affected by recalls, and providing guidance on clinical response for 122 VHA CIED clinics across the United States and Puerto Rico. The VHANCDSP promotes participation and adherence in RM, ensuring evidence-based care. The centralized infrastructure also positions the VHANCDSP to evaluate and implement quality improvement interventions, ultimately enhancing clinical care for patients with CIEDs. This article describes and reflects on this infrastructure and provides specific recommendations about how high-quality RM care can be provided in care other health care systems.
远程监测(RM)是心血管植入式电子设备(CIED)患者护理的核心。然而,由于RM护理给临床医生带来了巨大且不断增加的工作量,因此需要解决方案来提高护理效率。退伍军人健康管理局国家心脏设备监测计划(VHANCDSP)通过集中RM流程、审查所有RM传输、识别受召回影响的患者以及为美国和波多黎各的122家VHA CIED诊所提供临床应对指导,来满足这一需求。VHANCDSP促进了对RM的参与和依从性,确保了循证护理。集中式基础设施还使VHANCDSP能够评估和实施质量改进干预措施,最终加强对CIED患者的临床护理。本文描述并反思了这一基础设施,并就如何在其他医疗保健系统中提供高质量的RM护理提出了具体建议。