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Community-led treatment for heart failure

Dr Ciara Keane

Director of Operations, The Heartbeat Trust

The Heart Failure Virtual Consult; A novel way of using technology to deliver care into the community.

The problem

There are over 90,000 people in Ireland are living with heart failure with an estimated cost of €660 million. Many challenges remain in the management of heart failure. This includes a changing profile of older patients with multiple comorbidities and a high rate of hospital admissions. Use of modern communication systems has the potential to revolutionise heart failure care.

The solution

Heart failure, with the correct supports can largely be managed in the community. For example, for GPs the heart failure virtual consult (HFVC) provides multiple benefits including:

  • Dynamic learning environment,
  • Improved knowledge base,
  • Peer to peer support
  • …and most importantly the necessary supports to maintain and treat heart failure patients in the primary care setting.

The HFVC provides not only online, real time specific case discussion but also a dissemination of practical tips in heart failure care between GP and specialists. This offers an alternative to standard clinic assessment. Also it can provide GPs with all the information required, thus reducing need for onward referral. Therefore, it can reduce unnecessary travel for the patient and their family – a meaningful bonus given the age and frailty of many patients with heart failure.

Easier access for patients and GPs

By managing heart failure in the community, the HFVC removes a step in the traditional care pathway facilitating interaction between the specialist/GP in a cost effiecient manner. Moreover, the HFVC reduces the need for out-patient department referrals, freeing up hospital out-patient slots for those in need of standard clinics resulting in shorter waiting times and speedier reviews.

150 GPs have signed up across the East Coast, Midlands and the Carlow/Kilkenny region to date. 100% of GPs agreg that the HFVC advice was useful in treating their patients and that the patients themselves benefited as a result of their participation in the HFVC. The patients were also happy to have their conditions discussed with experts and groups of GPs and relieved not to have to travel to the hospital.

142 patients were referred to the service over the initial 18 month study period. In fact, only 17% required review in the outpatient department with the majority of issues dealt with through the HFVC service. The travel distance saved for patients referred to this service was 10,552km. GPs involved reported high usability and improvements.

eHealth is the future

We are passionate about the future advancement of eHealth in Ireland. Similarly, we are optimistic about the use of technology for wider dissemination of heart failure knowledge and community based care. Resourcing of this method of integrated care is required to ensure that both specialist and GP teams can participate fully without compromising other patient care. In conclusion, the use of this type of webconferencing is easily transferable to other disease areas nationally.

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