BOSTON – Remote monitoring of cardiovascular implantable electronic devices dramatically improved patient outcomes and cut health care costs by keeping patients out of the hospital and reducing lengths of stays when hospitalization was needed, a retrospective analysis showed.
Remote monitoring “led to improved outcomes, more convenience for patients, and saved money, truly a win-win-win,” in the study of real-world data collected on more than 92,000 U.S. patients during 2008-2013, said Dr. Jonathan P. Piccini Sr. in an interview at the annual scientific sessions of the Heart Rhythm Society.
Using the MarketScan database of U.S. patients covered by commercial insurance or Medicare, Dr. Piccini and his associates analyzed hospitalization records for 92,566 patients who received an implanted pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device during the study period. Roughly a third of the patients underwent remote monitoring along with their routine clinic visits while the rest were followed exclusively by clinic visits.
The data showed that remotely monitored patients had a statistically significant 18% lower rate of hospitalizations during follow-up and a 35% cut in their average length of stay when hospitalized. This resulted in a 30% drop in hospitalization costs, compared with costs for similar patients who did not undergo remote monitoring of their implanted devices. The cost savings remote monitoring produced meant that every 100,000 patient-years of remote monitoring saved about $370 million in hospital costs.
Coincident with the meeting, an expert panel of the Heart Rhythm Society released a statement on remote monitoring for cardiovascular implantable electronic devices (CIEDs) (Heart Rhythm 2015 [doi: 10.1016/j.hrthm.2015.05.008]. The statement said that “remote monitoring represents the new standard of care for patients with CIEDs.” But Dr. Piccini’s findings showed that U.S. clinicians vastly underused remote monitoring, with two-thirds of U.S. CIED recipients failing to undergo remote monitoring during 2008-2013. “Increased monitoring is a huge opportunity for health care improvement,” said Dr. Piccini, a cardiologist and an electrophysiologist at Duke University in Durham, N.C.
Dr. Piccini has been a consultant to Medtronic and has received research grants from Boston Scientific.
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