RPM Reduces 30-Day Mortality to Nearly Zero for Heart Bypass Procedures

In the past at Atrium Health’s Sanger Heart and Vascular Institute, as in many other hospitals, post-operative cardiac patients were discharged with a vague understanding of what recovery entailed. The uncertainty may lead to preventable poor outcomes and readmissions for issues that could have been managed in the outpatient setting.

Problem

Anxiety is common in patients preparing for cardiac surgery. Patients prefer to stay at home, but recovering from invasive surgery without expert guidance can be scary and dangerous.

Providers need up-to-date, reliable data to inform post-surgery decision-making, but that data is needed, said Dr. John Frederick, chief of cardiovascular surgery at Sanger Heart & Vascular, Atrium Health. Collecting and turning it into insights can be a daunting task. Institute.

“Prior to remote monitoring biometric data collection meant that nurse navigators had to rely on patients to manually record and report information,” he said.

Proposal

Health IT vendor Carium proposed a care experience platform to be added to Sanger Heart and Vascular’s Perfect Care program that provides a complete ecosystem for virtual care.

“The care experience platform will ensure that patients stay connected to their care teams, and that care teams stay connected to invaluable patient data to improve clinical decision making,” explained Frederick.

“A thoughtful change management strategy is critical to ensuring the smooth and successful implementation, transition, adoption and advocacy of a new virtual care platform.”

Dr. John Frederick, Sanger Heart and Vascular Institute of Atrium Health

“The platform will help care teams map out the recovery journey, establishing check-in dates and milestones that everyone can work towards,” he added.

The Care Experience Platform, he said, promises:

• Enable providers to spend less time on administrative tasks.
• Strengthen patient/provider relationships.
• Improve patient experience.
• Create a steady flow of biometric data between patients and providers.
• Help rural patients and those who lack support networks maintain critical relationships with their care teams.

meet the challenge

Patients download the Carium app and receive a digital health kit that includes a connected blood pressure cuff, weight scale, pulse oximeter and Google Fitbit to measure activity and sleep patterns.

As their care teams build stronger relationships with patients using the care experience platform, biosensors collect actionable, real-time data that they use to make ongoing evidence-based clinical decisions.

“The program brings together presurgery education, orientation and a strong relationship between patients and their clinical nurse navigators that persists at discharge and beyond,” explained Frederick. “This synergy not only makes for a more empathetic and satisfying working environment – ​​nurse navigators access important details about patients’ families, schedules and moods to personalize their treatment and strengthen the patient experience .

“The platform automatically surfaces key insights and signal thresholds, removing blind spots in the continuum of care, making it easier for the care team to know when intervention is needed and when it is not,” he continued .

The provider/patient relationship is no longer confined to the walls of a hospital – people can recover from complex heart surgery at home while maintaining vital virtual connections with the physicians they depend on, he added.

“Clinical nurse navigators notice that many patients take a more active role in their recovery, which helps with outcomes and satisfaction,” he said. “They enjoy sharing their metrics and often use monitoring tools after the 90-day observation period.”

Result

Atrium Health’s Perfect Care program streamlines operations, benefits patient outcomes and the bottom line. Frederick pointed out that the initiative is driving impressive results for patients and the health system. He added that the organization is providing better care at a lower cost and reducing unnecessary visits to the hospital.

“Thanks to the program, Sanger Heart & Vascular reduced 30-day readmissions by 40% and the average length of stay by one day,” he said. “The clinical results are equally impressive. The 30-day mortality rate for coronary artery bypass grafting is about 0.5% system-wide, but that number is nearly zero for patients in the virtual care program.

According to the Society for Thoracic Surgery, the national average is 2.5%.

Increased engagement between patients and care teams, as patients knew that help was always a call or text message away.

“Meanwhile, providers report improved patient relationships and more reliable access to timely, relevant patient data that provides insights when and where they are needed,” Frederick said. “Atrium Health has expanded the Atrium Care experience platform into its weight management, stroke, diabetes and hypertension programs, and is exploring broader implementation.”

advice for others

“Implementing virtual care technology can be a complex and challenging process – starting small and gradually expanding and customizing the implementation may be a more effective approach,” advises Frederick. “By starting with a small project, organizations can identify and address any issues before implementing the technology on a large scale.

“A thoughtful change management strategy is critical to ensuring a smooth and successful implementation, change, adoption and advocacy of a new virtual care platform,” he continued. “The fear of change is real, especially when it affects processes, workflows, and behaviors.”

Elements of a strong change management strategy can include communication, collaboration, education and identifying the right “first followers” who can confidently lead for colleagues and teams, they concluded.

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