The Bellvitge University Hospital and the Bellvitge Biomedical Research Institute (IDIBELL) have begun a telemedicine monitoring project for patients with chronic heart failure within the framework of the HERMeS clinical trial, in which 10 centers in Spain will participate. The principal investigator of the clinical trial is Dr. Josep Comín, head of the Cardiology Service of Bellvitge Hospital.

The HERMeS clinical trial, which already includes 200 patients, is the largest in Spain on the application of telemedicine and, more specifically, mHealth (use of mobile telephony in medical practice) in heart failure and also one of the most important internationally. Its objective is to try to confirm if this working method helps detect and treat decompensations more quickly and reduces the number of hospitalizations and the mortality of these patients. If the model works, then it could be transferred to other health processes, such as chronic patient care.

The telemedicine method evaluated uses a computer platform that has been designed for this purpose, PIRENe, as well as a mobile phone in which the app is installed through which the data is sent to the platform, and measuring devices that are delivered to the patient. At the initial visit, the patient is instructed on how to use them and, with them, daily monitors his blood pressure, heart rate and weight, in addition to filling out a symptom questionnaire. The doctor automatically receives these data and, if necessary, communicates with the patient. The working method also includes conducting visits by videoconference from mobile phone to mobile phone from the app.

The intervention with telemedicine lasts 6 months and is done in people who have recently been discharged from hospital due to some decompensation, a period in which there is a special vulnerability to suffer other similar episodes.

With a project of these characteristics, Bellvitge University Hospital and IDIBELL confirm their commitment to research in the service of better and more efficient patient care. Vodafone and the i2cat Foundation, a research center that promotes R & D & I activities in the field of health, collaborate in the initiative, among others.

In addition to Bellvitge, participants in this project are the SAP Delta Primary Care chronicity teams, Arnau de Vilanova Lleida University Hospital, Valencia University Clinical Hospital, Virgen de la Victoria University Hospital of Malaga, Central University Hospital of Asturias, Hospital of Manises, Puerta de Hierro-Majadahonda University Hospital, Viladecans Hospital and Sant Joan Despí Moisès Broggi Hospital.

 

Comprehensive patient care project

Heart failure is a major health problem. It is one of the most common pathologies worldwide, and its prevalence and incidence increase with age. It affects up to 10% of patients older than 75 years.

This initiative has been developed within the framework of the Territorial Program of Integrated Attention to Patients with Community Heart Failure of the Southern Metropolitan Management of the ICS, created at the end of 2016 with the objectives of improving the prognosis and quality of life of patients and reducing the first admissions and readmissions for heart failure.

Led jointly by the hospitals and by the primary care of the ICS in l'Hospitalet, this program is based on a transitional model, that is to say, maintenance of continuity of care, paying special attention in the first days after discharge.

It includes, among others, actions that are carried out within the hospital beyond the basic care activity, such as an educational intervention, a comprehensive assessment to early detect the fragile patient, or coordination at discharge, all of them with an essential role of Nursing.

Beyond the framework of conventional hospital admission, it includes: early visit after discharge, structured follow-up of the patient with individualized care plans, possible alternatives to hospitalization in case of decompensation, such as Medical Day Hospital, or patient transfers to other specialized teams if necessary, including the Bellvitge Advanced Heart Failure and Transplant Unit if complex and high-tech assistance is necessary.

The program is coordinated by the Multidisciplinary Unit of Attention to Community Heart Failure (UMICO) of Bellvitge and is made up of doctors and nurses specialized in heart failure of different services and units of this hospital (Heart Area, Internal Medicine, Geriatrics, Emergency, Unit of Short stay, home hospitalization...), of the primary care centers and primary care emergency centers (CUAP) of the territory, the Functional Unit for the Care of the Complex Chronic Patient (UFACC) and socio-health centers and residences.