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

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, Dominik Linz

Research output: Contribution to journalArticlepeer-review

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Abstract

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.

Original languageEnglish
Pages (from-to)130-139
Number of pages10
JournalNetherlands Heart Journal
Volume32
Issue number3
Early online date12 Jan 2024
DOIs
Publication statusPublished - Mar 2024

Keywords

  • Atrial fibrillation
  • Healthcare utilisation
  • Mobile health
  • Reimbursement

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