Amsterdam UMC to use e-health tool to remotely monitor heart patients at home

Patients and doctors at Amsterdam UMC’s Heart Centre can make use of the app HartWacht (HeartGuard, in English) to supplement their care. Through the use of a small measurement instrument, around the size of a cereal bar, and a mobile app, patients can now have their blood pressure and arrythmias monitored at home. This means that patients need to visit their cardiologist less frequently. For doctors, this means they have more precise measurements and can act quicker where necessary. A ”win-win” in the eyes of Michiel Winter, cardiologist at Amsterdam UMC and leader of this project.

“HartWacht was developed in 2016 by the Cardiology Centres Netherlands (CCN), an Amsterdam UMC partner. There, we are already using it to track data from more than 3,000 patients. Since we started the e-health program, 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. Analyses show that there are fewer visits to the emergency department, and that patients who use HartWacht come to the outpatient clinic less often and need fewer nursing days,” adds Winter, who in addition to his work at Amsterdam UMC is also chairman of CCN’s Board of Directors.

The HartWacht programme is suitable for patients who have high blood pressure, heart arrythmias or heart failure. For these patients, the use of this app will mean fewer trips to the hospital, both in ambulances and for check-ups. For the cardiologist, the app will allow them to work smarter, “It relieves us of our worries by collecting all of non-abnormal health measurements, so that we can focus on patients with abnormal measurements. It is necessary to filter the enormous amount of data from telemonitoring so that we can manage the workload,” says Jasper Selder, cardiologist at Amsterdam UMC and co-leader of this project.

Amsterdam UMC is the first academic hospital to use this program that makes it possible, among other things, to make an ECG remotely. The current HartWacht program is suitable for patients with high blood pressure, cardiac arrhythmias or heart failure. The app enables cardiologists to work smarter. “It relieves us of our worries because all non-abnormal health measurements are filtered out. That’s often the bulk of all measurements,” says Jasper Selder, cardiologist and biomedical engineer at Amsterdam UMC and co-leader of this project:

All patient data is analysed by a central team before any abnormal readings are shared with the patient’s cardiologist. “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,” Selder adds.

Winter’s experience is that home monitoring also offers peace of mind for patients who often have to deal with lifelong heart disease: “It is very reassuring for patients, they immediately receive feedback in the app after a measurement. In addition, it is a way to keep healthcare accessible and affordable. And because care becomes independent of time and place, we as doctors can help a patient much better and in a timelier manner. This leads to a high level of satisfaction of the participating patients and less unnecessary care,” he adds.

It is planned that programmes for diabetes and cardiovascular risk management will be added to the e-health programme this year. HartWacht is reimbursed by all Dutch health insurers.