ABSTRACT
OBJECTIVE: To assess the impact of a telemedicine program in which electrocardiogram (EKG), body weight and/or blood pressure are measured at home and medically trained personnel judge the transmitted data and council the patients by telephone. METHOD: We systematically studied the outcome and cost-effectiveness of the cardiac programs carried out by Shahal (SHL) during the past 19 years. RESULT: Most patients (85%) with acute complaints resembling coronary artery disease, could be reassured, representing a savings of about 677.000 euro per 10,000 members/yr in Israël in 1989, and a marked reduction in patient delay to 44 min (median). In chronic heart failure a 66% reduction in hospitalisation days was observed, together with an improvement in quality of life. A large Healthcare Insurance Company in Germany (Taunus BKK) has calculated that it can save at least 5 million euro per year with the use of such services. CONCLUSION: Disease management with concomitant telemedicine for coronary artery disease and chronic heart failure is safe and effective and has a huge potential for cost savings, improvements in quality of life and in prognosis of heart disease.
Subject(s)
Cardiology Service, Hospital , Coronary Artery Disease/therapy , Telemedicine , Ventricular Dysfunction, Left/therapy , Acute Disease , Aged , Chronic Disease , Coronary Artery Disease/economics , Delivery of Health Care , Germany , Humans , IsraelABSTRACT
Chronic heart failure (CHF) is an example of a disease that can benefit to a great extent from a combination of disease management, telemedicine and outreaching care by professionals. This article summarizes how experience has been built up since 15 years and how cost-effectiveness could be demonstrated in several studies. Tele-cardiology for CHF has proven it's value and is currently being applied successfully in Israel and Germany by SHL-telemedicine International LTD. The Dutch Ministry of Health has recently issued a positive recommendation to Health Insurance Companies to promote the use of telemedicine where feasible in these types of chronic ailments.
Subject(s)
Cardiology , Heart Failure , Chronic Disease , Heart Failure/therapy , Humans , Israel , TelemedicineABSTRACT
In this article we describe why and how a new approach has been developed for innovation projects in the Dutch healthcare sector. There are three key aspects in the approach: Innovation should be seen as a (fair) process, the process is owned by all stakeholders (which calls for a Network approach) and, finally, the process should be knowledge-enabled, i.e. in each process step it should be clear what knowledge is needed, what knowledge becomes available and how the flow of knowledge should be managed.
