Changes in healthcare utilisation during implementation of remote atrial fibrillation management: TeleCheck-AF project

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  • Monika Gawałko
  • Konstanze Betz
  • Veerle Hendriks
  • Astrid N.L. Hermans
  • Rachel M.J. van der Velden
  • Martin Manninger
  • Sevasti Maria Chaldoupi
  • Henk Hoogervorst
  • Herm Martens
  • Nikki A.H.A. Pluymaekers
  • Marieke D. Spreeuwenberg
  • Jeroen Hendriks
  • Dr Linz, Dominik Karl

Aim: To evaluate changes in healthcare utilisation and comprehensive packages of care activities and procedures (referred in the Netherlands to as ‘diagnose-behandelcombinatie (DBC) care products) during the implementation of the TeleCheck-AF approach (teleconsultation supported by app-based heart rate/rhythm monitoring) in a Dutch atrial fibrillation (AF) clinic. Methods and results: In the Maastricht University Medical Centre+ AF Clinic, data on healthcare utilisation and DBC care products for patients consulted by both a conventional approach in 2019 and the TeleCheck-AF approach in 2020 were analysed. A patient experience survey was performed. Thirty-seven patients (median age 68 years; 40% women) were analysed. With the conventional approach, 35 face-to-face consultations and 0 teleconsultations were conducted. After the implementation of TeleCheck-AF, the number of face-to-face consultations dropped by 80% (p < 0.001) and teleconsultations increased to 45 (p < 0.001). While 42 electrocardiograms (ECGs) and 25 Holter ECGs or echocardiograms were recorded when using the conventional approach, the number of ECGs decreased by 71% (p < 0.001) and Holter ECGs or echocardiograms by 72% (p < 0.001) with the TeleCheck-AF approach. The emergency department patient presentations showed no statistically significant change (p = 0.33). Overall, 57% of medium-weight DBC care products were changed to light-weight ones during implementation of the TeleCheck-AF approach. Patient satisfaction with the TeleCheck-AF approach was high. Conclusion: The implementation of TeleCheck-AF led to a change in healthcare utilisation, a change from medium-weight to light-weight DBC care products and a reduction in patient burden. These results created the basis for a new reimbursement code for the TeleCheck-AF approach in the Netherlands.

OriginalsprogEngelsk
TidsskriftNetherlands Heart Journal
Vol/bind32
Udgave nummer3
Sider (fra-til)130-139
ISSN1568-5888
DOI
StatusUdgivet - 2024

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