CHARLOTTE – Heart failure doesn’t have to mean the end of a mostly independent lifestyle at home. Two years ago, Charlotte Young, age 79, had a stroke. Shortly after, she was diagnosed with heart failure. Since then? “I am coming back to being my old self again. Every day, I am getting better and better,” she said.
What helped: Young participated in a remote patient monitoring program implemented in 2022 for some Novant Health heart failure and cardiac patients in the Charlotte area. Despite her heart condition and full-time supplemental oxygen use, Young has been able to largely manage her own care from the comfort of her home. She was referred to the program when transportation became an issue – she had previously been relying on family members to go to heart failure clinic appointments, so it was difficult to get there as often as she needed to.
Whether patients are undergoing simple monitoring or are also following home-based cardiac rehab plans, the main goal of remote monitoring and management is to keep them safe with the remote guidance of clinicians.
Patients in the program receive a computer pad, a handheld device with their care plan programmed into it and a kit with devices that allow them to record their weight, blood pressure, pulse, heart rate and oxygen saturation every day. This information goes directly into a portal, so patients don’t have to record anything manually.
“There are medication reminders in their computer pads, and patients click a button to confirm they took their medication,” said Jan Wagoner, director of cardiopulmonary rehabilitation at Novant Health. “Patients can also follow prompts and questions to tell us how they’re feeling, whether they’re experiencing shortness of breath, chest pain, or other symptoms. Just like their vital signs, this information is directly uploaded to the portal so Novant Health clinicians can see the information on their dashboard.”
In Young’s case, her care team identified a low oxygen level (also called hypoxic) reading using the monitoring equipment. She was able to quickly address it with a visit to her referring heart failure provider.
“It’s improved care for patients who face challenges in getting to frequent checkups,” Wagoner said. “It’s comprehensive. It enables us as clinicians to help patients faster and to do our best to keep them out of the hospital.”
Young was pleasantly surprised when she found out managing her care remotely was an option. “It really made a difference because I was monitoring myself and recording myself every day, which made me get into a regular routine,” Young said. “I was just amazed. The only thing I had to do myself was my own finger prick and punch in those readings. Everything else was automatic.”
Since launching in Charlotte, remote patient monitoring has already expanded to Matthews, Huntersville and Salisbury. Novant Health plans to expand the capability to all rehab programs across North Carolina.
Young misses her time in the program already. “It really got me onto the right path, to be very aware about what I eat and how much I weigh, what my water intake is, anything that affects blood pressure,” she said. “These are all things I need to be conscious of because of my stroke. Remote patient monitoring made me very conscious of my health.”
Now, she is self-monitoring with her own devices and recordkeeping. “So anytime I talk to my nurse, I can tell her right off what my blood pressure is or what my temperature is, how I feel. The program taught me how to keep a good record.”
While Young’s program was focused on monitoring and management of her condition, certain other patients who participated in the pilot program used the additional home-based cardiac rehab capabilities that are tailored for each patient.
“Educational videos programmed by the Novant Health team can give patients the information they need, from nutrition lectures to coaching sessions,” Wagoner said. “Patients can also receive an exercise plan that’s safe for their individual needs. This plan includes exercise logs with progressive guidelines on what to do to boost their program to get stronger.”
Young recommends the program to other heart failure and cardiac patients, whether they just need monitoring and management, or a built-in rehab program as well.
If you want to know what’s going on and have some control of it, you need to ask your doctor about it, Young said. “It was easy enough to do, you just have to follow the directions. It helps you to know if you are exercising enough and eating right – it just pinpoints everything and makes you conscious of what’s going on inside your body. It helped me get organized and make certain changes to improve.”