In the U.K., heart failure is the cause of 5 percent of the emergency hospital admissions and costs 2 percent of the total NHS budget. A significant percentage of hospital visits for this condition can be avoided by educating patients and caregivers to manage the condition at home.
The National Health Service (NHS) has introduced a new initiative, Managing Heart Failure @home, that employs remote monitoring tools to enable people to manage heart failure at home with adequate support. This initiative can reduce in-person appointments and avoidable hospital admissions and readmissions.
The @home approach involves working with heart failure care specialists alongside virtual wards to ensure clinically safe remote interactions that cater to individual needs. It has three main elements: personalized care, remote support and monitoring, and integrated care.
Personalized care includes listening to and educating people on managing their own health. It also includes referrals to the local social prescribing link workers and community support to ensure a holistic fulfillment of people’s needs. Rehabilitation EnAblement in Chronic Heart Failure (REACH-HF) is an example of this approach, which is an at-home cardiac rehabilitation for heart failure and self-management program.
Another element of @home is remote support and monitoring. It involves remote patient monitoring (RPM) through optimal use of technology. The RPM enables the doctors to adjust medications and take timely actions if the patients report a deteriorating condition. People can report their symptoms directly to heart failure specialists through the web, apps, or telephone. The Imperial College Healthcare NHS Trust is using Bluetooth-enabled remote monitoring devices to share information directly with the clinicians.
The third core element of @home is integrated care, which addresses the lag in coordination between the primary, secondary, and community care. It aims to improve coordination by categorizing the patients’ needs and bringing together the teams of clinicians.
@home approach is not about stopping face-to-face care. It is about enabling heart failure services to work in the most efficient way possible. Flexibility in the system would help enable various ways of working. Live care would still be offered to whoever needs it.