Coordination of a remote mHealth infrastructure for atrial fibrillation management during COVID-19 and beyond: TeleCheck-AF

Velden, Rachel M J van der; Hermans, Astrid N L; Pluymaekers, Nikki A H A; Gawalko, Monica; Vorstermans, Bianca; Martens, Helmut; Buskes, Saskia; Crijns, Harry J.G.M.; Linz, Dominik; Hendriks, Jeroen

doi:10.1177/2053434520954619

Cited by 14 publications

(16 citation statements)

References 17 publications

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“… 13 Additionally, information about strategies to educate and empower patients to self-manage the on-demand mHealth application and the required care coordination, including implementation of the approach in clinical practice, were provided. 8 The standardized instruction for all participating centres through an initiation call with a simultaneous discussion of the TeleCheck-AF project rationale appeared to facilitate the mHealth usage in the included centres.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the app provides educational information about AF, its complications and treatment. 8 If needed, patients can contact the physician prior to the planned teleconsulatation in case of alarming symptoms. Before the teleconsultation, the treating physician, general practitioner and AF-nurse have access to the cloud to evaluate the measurements.…”

Section: Methodsmentioning

confidence: 99%

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The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences

et al. 2021

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Aims TeleCheck-AF is a multicentre international project initiated to maintain care delivery for patients with atrial fibrillation (AF) during COVID-19 through teleconsultations supported by an on-demand photoplethysmography-based heart rate and rhythm monitoring app (FibriCheck®). We describe the characteristics, inclusion rates, and experiences from participating centres according the TeleCheck-AF infrastructure as well as characteristics and experiences from recruited patients. Methods and results Three surveys exploring centre characteristics (n = 25), centre experiences (n = 23), and patient experiences (n = 826) were completed. Self-reported patient characteristics were obtained from the app. Most centres were academic (64%) and specialized public cardiology/district hospitals (36%). Majority of the centres had AF outpatient clinics (64%) and only 36% had AF ablation clinics. The time required to start patient inclusion and total number of included patients in the project was comparable for centres experienced (56%) or inexperienced in mHealth use. Within 28 weeks, 1930 AF patients were recruited, mainly for remote AF control (31% of patients) and AF ablation follow-up (42%). Average inclusion rate was highest during the lockdown restrictions and reached a steady state at a lower level after easing the restrictions (188 vs. 52 weekly recruited patients). Majority (>80%) of the centres reported no problems during the implementation of the TeleCheck-AF approach. Recruited patients [median age 64 (55–71), 62% male] agreed that the FibriCheck® app was easy to use (94%). Conclusion Despite different health care settings and mobile health experiences, the TeleCheck-AF approach could be set up within an extremely short time and easily used in different European centres during COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences

et al. 2021

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“…Therefore, it is of significant importance to prepare patients for such role, by means of 3 Es: engagement : identify the patients’ needs, values, and preferences; provide clear education and instruction in a way that patients understand what is expected from them; and encourage them to undertake self-management (i.e., measuring vital parameters) and involve them in informed or shared decision-making regarding their AF treatment. This novel approach may require significant changes and redesign in the delivery of care [8].…”

Section: Discussionmentioning

confidence: 99%

On-Demand Mobile Health Infrastructure for Remote Rhythm Monitoring within a Wait-and-See Strategy for Recent-Onset Atrial Fibrillation: TeleWAS-AF

et al. 2021

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Recently, we introduced the TeleCheck-AF approach, an on-demand mobile health (mHealth) infrastructure using app-based heart rate and rhythm monitoring for 7 days, to support long-term atrial fibrillation (AF) management through teleconsultation. Herein, we extend the mHealth approach to patients with recent-onset AF at the emergency department (ED). In the proposed TeleWAS-AF approach, on-demand heart rate and rhythm monitoring are used to support a wait-and-see strategy at the ED. All stable patients who present to the ED with recent-onset symptomatic AF and who are able to use mHealth solutions for heart rate and rhythm monitoring are eligible for this approach. Patients will receive both education on AF and instructions on the use of the mHealth technology before discharge from the ED. A case coordinator will subsequently check whether patients are able to activate the mHealth solution and to perform heart rate and rhythm measurements. Forty hours after AF onset, the first assessment teleconsultation with the physician will take place, determining the need for delayed cardioversion. After maximal 7 days of remote monitoring, a second assessment teleconsultation may occur, in which the rhythm can be reassessed and further treatment strategy can be discussed with the patients. This on-demand mHealth prescription increases patient involvement in the care process and treatment decision-making by encouraging self-management, while avoiding excess data-load requiring work-intensive and expensive data management. Implementation of the TeleWAS-AF approach may facilitate the management of AF in the ED and reduce the burden on the ED system, which enhances the capacity for health care utilization.

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“…As pointed out by Maines et al, a team and coordination of care is critical for the implementation of such a mHealth approach. They dedicated a small group of doctors and nurses to set up a tele-infrastructure [5] . Patients profit from structured information and education about mHealth use [4] .…”

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Remote management and education in patients with cardiovascular conditions during COVID-19 and beyond

Linz¹,

Velden²,

Gawałko³

et al. 2020

IJC Heart & Vasculature

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Coordination of a remote mHealth infrastructure for atrial fibrillation management during COVID-19 and beyond: TeleCheck-AF

Cited by 14 publications

References 17 publications

The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences

The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences

On-Demand Mobile Health Infrastructure for Remote Rhythm Monitoring within a Wait-and-See Strategy for Recent-Onset Atrial Fibrillation: TeleWAS-AF

Remote management and education in patients with cardiovascular conditions during COVID-19 and beyond

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