Authors' objectives:

This report aims to assess the effectiveness of remote physiological monitoring (or telemonitoring) of patients with congestive heart failure (CHF).

Authors' recommendations: The burden of caring for patients with chronic diseases on caregivers and health systems, such as VHA, is driving the need to optimize outcomes management and quality improvement strategies for these patients. Telemedicine is not new to health care, since electronic media have been used to transmit health care information for several years. However, technical innovations in telemedicine coupled with the need to optimize finite health care resources are important motivating factors for using telemedicine to change the delivery of patient care. Physiologic telemonitoring is quickly evolving and is being marketed as a way to contain costs and improve functional status and quality of life. Results from this short report and other reviews assessing the broader scope of telemedicine confirm that optimal strategies for managing patients with chronic diseases like CHF in the community setting have not been established. In the broader scheme of multiple management strategies, the relative value of telemonitoring must be considered in the context of other telemedicine alternatives and of non-telemedicine care systems. To that end, the reviews identified in this report provide general considerations and frameworks for assessing telemedicine that may be useful in designing cost-effectiveness studies. Likewise, Noel and Vogel (2000) offer useful insights into study design and conduct learned from their pilot study in the context of delivering VA patient care. This study may assist other VA researchers and practitioners in designing longitudinal studies to explain the influence of telemonitoring, as part of models of delivery and coordination of care, on objective and subjective outcome measures. VHA research has made notable contributions to outcomes research in managing chronic disease and continues to explore ways to provide veterans with the most costeffective care. VHAs Quality Enhancement Research Initiative (QUERI), led by the Health Services Research and Development Service, is designed to translate research discoveries and innovations into better patient care and systems improvements. CHF QUERI was developed to create measurable, rapid, and sustainable improvements in the quality of care and health outcomes of veterans with CHF. These research efforts, coupled with ongoing evaluation activities in clinical care identified in this report, put VHA in a principal position to make significant contributions to the quality of care and health outcomes of patients with CHF.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/PhysiologicMontioringCHF2001tm.pdf

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: Technology Assessment Unit, Office of Patient Care Services, US Department of Veterans Affairs (VATAP)