Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 19;1(2):97-106.
doi: 10.1016/j.cvdhj.2020.09.003. eCollection 2020 Sep-Oct.

Patient responses to daily cardiac resynchronization therapy device data: A pilot trial assessing a novel patient-centered digital dashboard in everyday life

Tammy Toscos  1   2 , Carly Daley  1   2 , Shauna Wagner  1 , Amanda Coupe  1 , Ryan Ahmed  1 , Richard J Holden  3   4 , Mindy E Flanagan  1 , Rachel Pfafman  1 , Romisa Rohani Ghahari  1 , Michael Mirro  1   2   3
Affiliations

Patient responses to daily cardiac resynchronization therapy device data: A pilot trial assessing a novel patient-centered digital dashboard in everyday life

Tammy Toscos et al. Cardiovasc Digit Health J. .

Abstract

Background: Heart failure (HF) is a growing public health problem in the United States. Implantable cardiac resynchronization therapy (CRT) devices reduce mortality and morbidity, and remote monitoring (RM) of these devices improves outcomes. However, patient RM adherence is low, due in part to lack of access to their RM data. Providing these data to patients may increase engagement, but they must be appropriately tailored to ensure understanding.

Objective: The purpose of this study was to examine patients' experiences interacting with their RM data through a novel digital dashboard as part of daily life.

Methods: In this mixed-methods pilot study, 10 patients with implantable CRT defibrillators were given access to a patient-centered RM data dashboard, updated daily for 6-12 months. Pre- and post-health literacy, engagement, electronic portal (MyChart, Epic Systems Corporation) logins, and RM adherence were measured; system usability scores were collected at exit; and dashboard views were tracked. Exit interviews were conducted to elucidate patients' experiences.

Results: Participants (100% white; 60% male; age 34-80 years [mean ± SD: 62.0 ± 13.4]) had adequate health literacy, increased MyChart logins (P = .0463), and nonsignificant increase in RM adherence. Participants viewed their dashboards 0-42 times (mean 14.9 ± 12.5). Interviews revealed participants generally appreciated access to their data, understood it, and responded to changes; however, questions and concerns remained regarding data interpretation and visualization.

Conclusion: Preliminary findings support potential future integration of a CRT RM data dashboard in the daily care of HF patients. With appropriate informational support and personalization, sharing RM data with patients in a tailored dashboard may improve health engagement.

Keywords: Biventricular pacing; Cardiac implantable electronic devices; Consumer health informatics; Data transparency; Heart failure; Left ventricular pacing; Patient engagement; Patient portal; Personal health record; Remote monitoring.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study flowchart. Participant screening, enrollment, and completion of study, as well as a summary of inclusion and exclusion criteria. All participants received the dashboard for 6–12 months between enrollment and exit interview.
Figure 2
Figure 2
Patient-facing dashboard. A novel, patient-facing cardiac resynchronization therapy–defibrillator data dashboard featuring a 5-week average percent left ventricular (LV) pacing zone; here, the percent LV pacing is in the yellow zone (between 85% and 92%).
Figure 3
Figure 3
Daily percent left ventricular (LV) pacing over 5 weeks. The daily percent LV pacing values (5-week look-back) were available through a link from the full dashboard. Each bar is 1 day, and the color represents the percent pacing for that day.
Figure 4
Figure 4
Research procedure for updating dashboards and tracking activity. Researcher activities for retrieving daily transmission data, uploading it to the dashboard, and notifying participants of changes in percent left ventricular pacing. RM = remote monitoring; URL = uniform resource locator.
See this image and copyright information in PMC

References

    1. Yancy C.W., Jessup M., Bozkurt B., et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;62:e147–e239. - PubMed
    1. Casale J.C., Wolf F., Pei Y., Devereux R.B. Socioeconomic and ethnic disparities in the use of biventricular pacemakers in heart failure patients with left ventricular systolic dysfunction. Ethn Dis. 2013;23:275–280. - PubMed
    1. Koplan B.A., Kaplan A.J., Weiner S., Jones P.W., Seth M., Christman S.A. Heart failure decompensation and all-cause mortality in relation to percent biventricular pacing in patients with heart failure: is a goal of 100% biventricular pacing necessary? J Am Coll Cardiol. 2009;53:355–360. - PubMed
    1. Slotwiner D., Varma N., Akar J.G., et al. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm. 2015;12:e69–e100. - PubMed
    1. Hindricks G., Varma N., Kacet S., et al. Daily remote monitoring of implantable cardioverter-defibrillators: insights from the pooled patient-level data from three randomized controlled trials (IN-TIME, ECOST, TRUST) Eur Heart J. 2017;38:1749–1755. - PMC - PubMed