Remote cardiac e-health tool drives efficiencies and improves patient care in Amsterdam

26th February 2024

An e-health programme developed by the Cardiology Centres Netherlands (CCN) has been rolled out to patients at Amsterdam UMC’s Heart Centre to supplement their care and support cardiologists.

The HartWacht mobile app (HeartGuard, in English) is suitable for patients with high blood pressure, cardiac arrhythmias or heart failure and uses a small measurement instrument, around the size of a cereal bar, to monitor their blood pressure and arrythmias at home.

Making it possible to take an ECG remotely, the app means patients need to visit their cardiologist less frequently. It also gives clinicians more precise measurements and enables them to act faster where necessary.

Amsterdam UMC is the first academic hospital to use this e-health programme, which was developed in 2016 by CCN where it is already being used to track data from more than 3,000 patients.

Michiel Winter, cardiologist at Amsterdam UMC, leader of the HartWacht project, and chairman of CCN’s Board of Directors, said: ‘Since we started the e-health programme we have seen a decrease in the number of ambulance-calls for these patients, and, because we can see what is going on with the patient from a distance, we can immediately reassure and advise or intervene where necessary.’

In addition, CCN analyses show the system results in fewer visits to the emergency department, and that patients who use HartWacht come to the outpatient clinic less often and need fewer nursing days.

Dr Winter said home monitoring with the e-health tool offers peace of mind for patients who often have to deal with lifelong heart disease. ‘It is very reassuring for patients [as] they immediately receive feedback in the app after a measurement,’ he added.

Clinicians can also help patients in a timelier manner with less unnecessary care, as all patient data collected by the app is analysed by a central team before any abnormal readings are shared with the patient’s cardiologist.

Jasper Selder, cardiologist and biomedical engineer at Amsterdam UMC and co-leader of the e-health project, said: ‘It relieves us of our worries because all non-abnormal health measurements are filtered out – often the bulk of all measurements – so that we can focus on patients with abnormal measurements.

‘As a cardiologist, instead of having to look at dozens of heart rhythm and blood pressure measurements during the – often busy – outpatient check-ups, we now receive an immediate notification if one of those measurements falls outside the expected range, so there is more time for the cardiologist to focus on patient care.

‘Deviations also come to light more quickly and not only during checks. Based on the abnormality detected, we can immediately determine whether action is needed, such as adjusting medication or an extra check-up.’

According to Amsterdam UMC, further applications for diabetes and cardiovascular risk management will be added to the e-health programme this year.

New app aims to reduce blood clot risk and prevent hospitalisation

18th December 2023

A new app providing information on blood clots and how to reduce the risk of developing one has been developed by Oxford University Hospitals NHS Foundation Trust and Thrombosis UK for at-risk patients.

The ‘Let’s Talk Clots’ app will be advertised on discharge paperwork for patients hospitalised with thrombosis, deep vein thrombosis, pulmonary embolism and venous thromboembolism (VTE). 

It shares medically-approved, key information about clots, including reducing risk, the signs and symptoms, diagnosis and UK approved treatments and therapies.

There are also details on recovery, including pain and breathlessness, managing anxiety and worry, regaining wellbeing, fitness and returning to everyday activities.

The app also aims to help prevent hospitalisations from blood clots by outlining considerations around risk factors such as pregnancy, family planning, travel and work and managing other conditions or treatments alongside risk factors or a personal medical history of thrombosis.

The app is also being promoted via postcards and posters around the trust‘s hospital sites in Oxford and Banbury, and the team hopes to include the app‘s details on patients‘ admission paperwork in future.

Sarah Havord, a VTE prevention nurse at Oxford University Hospitals and blood clot prevention specialist, said: ‘This resource is very much needed, providing free access to medically-approved information across the blood clot journey and, I believe, will help to save lives and restore lives affected by blood clots.

‘The app started simply as an idea of mine, and has been developed in collaboration with Thrombosis UK, allied healthcare professionals, individuals who have been diagnosed with a blood clot, and their family members. I have been overwhelmed by the amount of support and help provided.‘

The NHS estimates that one in 20 people will experience a VTE during their lives. It is also linked with hospitalisation, with an estimated 55-60% of VTE cases occurring during or after a hospital stay.

Covid-19 has particularly affected awareness of thrombosis, with a paper published in the journal Thrombosis Research reporting a 31% incidence of thrombotic complications in ICU patients with Covid-19.

The app is now available for download for both Apple and Android users.

Digital health the key to improvements for cardiovascular disease

29th September 2021

Harnessing advances in digital health to improve awareness, prevention and management of CVD globally is the theme for World Heart Day 2021.

World Heart Day (WHD) was created by the World Heart Federation in 2000 and since that time, 29th September has been designated annual WHD. The purpose of WHD is to inform people across the globe of the simple fact that cardiovascular disease (CVD), remains the world’s leading cause of death. According to figures produced by the World Health Organisation, in 2020, CVD resulted in an estimated 17.9 million deaths. Perhaps the most disheartening aspect of this enormous death toll, is that 80 per cent of premature heart disease and stroke is preventable. While the theme of the 2021 WHD is “heart to connect”, i.e., harnessing the power of digital health to improve awareness, prevention and management of CVD globally, what is the evidence for the impact of digital health on cardiovascular disease outcomes?

Digital innovations in cardiology

The term “digital health” encompasses a number of technologies including electronic and mobile health platforms (eHealth and mHealth), telemedicine, wearable devices, sensors and artificial intelligence (AI). The European Society of Cardiology, has a section on its website looking at digital health in action, with a number of examples of how technologies are being used to support both clinicians and patients.

Taken together, each of these innovations is designed to improve both access to and delivery of, healthcare. There are already many examples of the value of digital technologies in cardiology, for instance, in the provision of health education, tele-rehabilitation as well as for disease prediction (e.g., AI systems) and even vital sign monitoring as witnessed by improvements in wearable devices.

Cardiovascular medicine it seems, has embraced digital health innovations for many years as demonstrated in a 2015 systematic review and meta-analysis. The review included 51 studies and assessed the impact of digital innovations on cardiovascular outcomes such as CVD events, all-cause mortality compared to control groups without such interventions. Overall, there was a 39% reduction in CVD outcomes accompanied by reductions in weight and body mass index, compared to controls. Additionally, a 2019 review, found that heart failure and stroke were the two most common cardiovascular conditions that were managed with digital health interventions. Perhaps most important, was the conclusion in which the authors stated that “the majority of the studies were good quality cost-effectiveness analyses with an adequate duration of time frame” and that “all the included studies found the DHIs [digital health interventions] to be cost-effective.”

Despite these promising developments, one major barrier that remains, is changing modifiable cardiovascular lifestyle factors such as smoking, reducing alcohol intake and increased levels of physical exercise. Nevertheless, it seems that digital health may also be part of the solution. In a review of studies with digital technology such as mobile phones, the internet, smartphone apps and wearables, the authors found that these innovations may improve some modifiable lifestyle measures such as healthy eating and greater levels of physical activity and that interventions were certainly more effective when used in combination.

Perhaps one of the biggest drivers for the incorporation of digital health in medicine as a whole, has been the current COVID-19 pandemic. With many countries forced to impose many national lockdowns, healthcare systems had to quickly evolve and adopt digital measures to maintain some level of services. Moving forward, digital health should now be perceived as part of the new normal for cardiovascular services and which hopefully should allow for the successful implementation of the aspirations of World Heart Day 2021.