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Telehealth service for patients with advanced heart failure

The practice introduces specific remote monitoring of patients with Congestive heart failure, structural damage of myocardium and left chamber dysfunction through the deployment of telehealth services and enhances relevant medical protocols. This new practice is to detect as many patients with the given diagnoses as possible, deploy telehealth services for monitoring and improved treatment of these patients. Appropriate care protocols will be enhanced and standardized, based on evaluation of results of telemonitoring in practice. The telehealth service consist of telemonitoring with clinical protocol that is in line with protocol used in an large EU project Unite4Health (www.united4health.eu) that focused on assessing the impact of innovative healthcare services in real conditions in 14 regions of Europe. This clinical protocol is extended by several ICT based features that are enabled by service portal. These features increase technical reliability of distant communication between patient (gateway) and healthcare personnel (nurse, cardiologist with access to telehealth portal), provide fast drug ordering tool and enable bidirectional communication with the patient. This practice is updated innovation that has been originally developed in 2012 and was also evaluated in the context of EIP on AHA Reference sites call in 2013.
Background
Geographical scope: 
National level
Region involved:
Countries involved:
Organisation
Organisation name: 
University Hospital Olomouc - Czech National eHealth Center
Organisation address: 
I.P.Pavlova 185/6, 779 00 Olomouc, Czech Republic
Kind of organisation: 
Hospitals
Research centres
Academia
Viability
Time for deployment: 
Less than a year
Preparation of implementation: 
Care protocols related to CHF were analyzed and optimal position and role of telemonitoring and other ICT tools was defined and negotiated with stakeholders (medical, organizational) within the hospital. Training for personnel and patients was developer, including written material with instructions...
Investment per citizen / service user / patient: 
Between 1.000 – 5.000 EUR per targeted citizen / patient
Cost calculation: 
The initial investment was higher as the entire infrastructure for the innovation must have been built. It includes time of workforce preparing and running the practice (incl. support), procuring the telehealth system and associated logistics. The cost per patient decrease with increasing number of...
Evidence of practice: 
Documented evidence. Evidence is based on systematic qualitative and quantitative studies
Evidence creation: 
Evidence behind the practice was part of results of our deployment site in Unite4Health project. Clinical evidence is based on analysis of evidence provided by based medicine resources (were also bases of Unite4Health project). Evaluation of the practice was completed and methodology MAST – Model...
Maturity level: 
There is evidence that the practice is economically viable and brings benefits to the target group. Further research and development is needed in order to achieve market impact and for the practice to become routine use
Maturity level detalis: 
The practice is beneficial to patients, the hospital and even the healthcare system. However, its economic viability is still subject of negotiation (status May 2016) with appropriate authorities. The negotiations are ongoing on several levels including Ministry of Health of the CR (strategic...
Time of impact: 
Long term and sustainable impact – e.g. a long time after the pilot project ended and routine day-to-day operation began
Kind of impact: 
Better health (societal)
Aspects time of impact: 
The impact of the intervention was in increased quality of care of the patients, namely due early intervention thanks to the practice that reduced deterioration of the patients condition. Reduction of rehospitalisation is approx. 40%. The patients better adhere to medication and have better access...
Transferability level: 
The innovative practice has been transferred within the same country.
Transferability details: 
The practice has been transferred also to other region in the CR and is performed in a reference health institute in Prague (IKEM). Scaling up to other hospitals can follow, however the team in NTMC concentrates on organizational aspects of such telehealth service, especially economic conditions,...
Initiative
Type of Practice: 
Good practice
Stakeholders concerned: 
Hospitals
Specialised physicians
Research centres
National public authorities , WHO
Other, please specify
Medical society - Cardiology
Reach of initiative: 
100 - 249
Age group: 
50 - 64
65 - 79
80+
Baseline information: 
This good practice has introduced minimum organizational changes within the hospital complying with national healthcare system and care protocols. It integrates medical practices and protocols with carefully selected telehealth services to primarily increase care of patients with advanced stages of...
Source of funding: 
National funding
Other funding: 
EU Structural funds, EU program CIP