Congestive heart failure or CHF continues to be the leading cause of hospital admissions and readmissions for people above 65 years old in the United States. At 26.9% of the total readmission rate, CHF accounts for the highest 30-day rehospitalization rate among medical and surgical conditions. In fact, 1 in 4 heart failure patients is reported to be re-admitted within 30 days of hospital discharge.
Limiting readmissions can significantly lower the cost of care. The Centers for Medicare & Medicaid Services (CMS), in its effort to reduce the costs associated with preventable readmissions, began examining readmission rates and introduced the Hospital Readmission and Reduction Program (HRRP) in 2012. Through this program, CMS imposes heavy penalties on hospitals with high readmission rates for CHF and other specific conditions.
Since the introduction of HRRP, hospitals have been searching for innovative ways to reduce readmissions. Some measures that can be undertaken include improving patient education at discharge, scheduling post-discharge appointments, implementing home healthcare programs, and automating patient communication.
This article examines how telehealth and remote patient monitoring can help with patient care and education upon discharge. But first, let’s look at some basic information on CHF that can be useful in educating patients.
Educating Patients on Congestive Heart Failure
According to the American Heart Association, heart failure occurs when the heart muscle fails to pump enough blood to meet the body’s need for blood and oxygen. The heart pumps oxygen and nutrient-rich blood to body cells. A weakened heart can’t supply the cells with enough blood, causing the body's functions to deteriorate.
Other than lifestyle-related reasons such as poor diet, sedentary lifestyle, smoking, obesity, and stress, CHF is also caused by underlying medical conditions that damage the heart muscles, including:
- Coronary heart disease
Coronary heart disease happens when the arteries supplying blood to the heart are clogged with fatty deposits, forming plaque. The plaque build-up can partially or totally block blood flow to the heart muscle, affecting oxygen supply and nutrients to the heart. Coronary heart disease can lead to heart attack, and if the artery is completely blocked, it causes permanent damage to the heart muscle.
Most cardiomyopathy cases are inherited and seen in children and younger people. It is a generic term used to describe diseases of the heart muscles. Cardiomyopathy causes the heart to stiffen, enlarge, or thicken and, in rare cases, leads to scar tissue. And as a result, the heart muscle does not pump or relax normally.
- Heart valve disease
Our hearts have four valves that ensure blood flows in the correct direction. When one or more valves don’t open and close properly, blood flow through the heart and body will be disrupted. There are several types of heart valve disease, including valvular stenosis, which is caused by stiff or fused valve leaflets, and valvular insufficiency, caused by a leaky valve.
- High blood pressure
Individuals with high blood pressure or hypertension are more susceptible to CHF. This is because hypertension increases the pressure inside the blood vessels. High blood pressure causes the arteries to lose stretchiness and become stiff or narrow, making it difficult for blood to travel. Over time, the heart thickens and becomes less efficient.
Heart failure symptoms vary from person to person. The symptoms can be sudden or develop gradually over weeks or even months. The most common heart failure symptoms include:
- Shortness of breath
- Fatigue and weakness
- Light-headedness or dizziness
- Swollen legs, ankles, and feet
- Swelling of the abdomen area
- Rapid or irregular heartbeat, even while resting
- Rapid weight gain from fluid build-up
- Unintentional weight loss in severe cases
Diagnosis of CHF begins with a thorough review of medical history and symptoms. Doctors will also check for other health conditions that may increase the risk of heart failure. Next will be a physical examination that includes listening to the lungs for signs of fluid build-up and the heart for whooshing sounds or murmurs.
After the historical and physical review, the doctor may also run any of the following tests:
- Blood test
- Chest X-Ray
- Electrocardiogram (ECG)
- Stress test
- Coronary angiogram
- Myocardial biopsy
- Other imaging tests
CHF is a chronic condition that requires lifelong management. However, with advancements in science and technology, more treatment options are available for CHF than ever before. Although the common goals of treating CHF are easing the symptoms, improving the quality of life, and in severe cases, lowering the risk of death and hospitalization, doctors sometimes can correct heart failure by treating the underlying cause.
For example, using a device to control the heart rhythm or repairing a heart valve to ensure the correct flow of blood. Patient education is also as important as the other medical interventions since an informed patient is more likely to take charge of their post-treatment care upon discharge.
How Telehealth and RPM Help with Post CHF Treatment
Studies show that telehealth and remote patient monitoring (RPM) effectively reduce heart failure rehospitalization and mortality. Remote monitoring options empower patients by educating them on CHF causes, symptoms, and treatment. It also allows patients who underwent treatment to access quality care from the convenience of their homes. Physicians, too, can monitor the vital signs recorded and plan necessary interventions if there are any abnormal readings.
This not only helps reduce the readmission rate but also creates a comfortable environment for patients to comply with treatment protocols and take control of their health without disrupting their daily routine.
With telehealth and RPM, patients and physicians can monitor:
Patients participating in the telehealth and RPM program use special Bluetooth devices, like an electrocardiogram, a blood pressure cuff, pulse oximeter, and weighing scales to keep a close tab on their vital signs. Information on their body weight, blood pressure, heart rate and rhythm, oxygen saturation, and self-rated health status will be transmitted to the Clinician monitoring portal. Patients can also use special wearables such as a FitBit to track exercise routines.
Telehealth and RPM educate patients and provide physicians with the tools to monitor their patients’ medication adherence. With telehealth, patients can keep in close communication with their healthcare providers, set daily routines to take medications and keep an electronic schedule with alerts. For physicians, telehealth can help make the adherence process friendly, educate patients on the reasons and benefits of their medication, and send alerts on medication or lifestyle regimens.
Diet and Lifestyle
On top of monitoring vital signs and medical adherence, telehealth and RPM can also be leveraged to educate patients on diet and lifestyle changes that can help in CHF management. When patients are involved in their health management and understand why they need to adhere to specific dietary and lifestyle changes, they are more likely to participate in the intervention plans even when they are outside the hospital setting.
How HRS Can Help You with CHF Patient Education
Telehealth and RPM have proven to be effective education delivery systems for patients with CHF. At HRS, we have the technology and experience to implement remote patient monitoring programs that fit your need.
As part of our patient education program for CHF patients, we have an extensive video library that includes the following videos:
- What is Heart Failure?
- Your Heart Failure Management Plan
- Heart Failure: Making Lifestyle Changes
- Heart Failure: Monitoring for Signs and Symptoms
- Managing Heart Failure: Limiting Sodium
- Managing Heart Failure: Exercising Safely
- Managing Heart Failure: Energy Conservation Emotions of Heart Failure
To learn more about our bluetooth peripherals, patient education videos, and overall CHF programs, talk to one of our digital health specialists today!