An Atrium Health pilot program aims to improve health care through the use of emerging technologies. Think Fitbits, smart scales and “the medical equivalent of Facetime.”
These types of tools will be incorporated as part of the initiative called Perfect Care: Personalized Cardiac Care and Collaborative. Atrium Health Foundation received a $1.1 million grant from The Duke Endowment to fund the three-year pilot.
Perfect Care will make it so that cardiovascular patients won’t have to leave home to connect with their doctor, which otherwise can be a struggle for people living in rural areas. Doctors will check on patients before and after procedures through two forms of remote monitoring: active and passive.
Active monitoring can be thought of as a webcam checkup. An app on patients’ smartphones, tablets and computers will allow doctors to connect with them virtually.
“(We can) figure out how they’re doing, look at wounds and respond to whatever the demands may be, as frequently as daily if necessary,” says Dr. Kevin Lobdell, director of regional cardiac, vascular and thoracic surgery quality, education and research at Atrium Health.
Passive monitoring uses activity trackers, Bluetooth-enabled scales and other devices, depending on the patients’ needs. These tools – which measure weight, heart rate, sleep and other data – will be grouped into a “digital health kit,” which participants will receive for free as part of The Duke Endowment funding. The data collected goes in the cloud and is available to Atrium doctors for evaluation.
“We can find out if somebody, for instance, was retaining fluid and their weight was increasing, and if that was a sign that maybe they weren’t recuperating the way that we would like them to,” Lobdell explains.
If all goes as planned, hospitals could be one step closer to closing the rural health-care gap. People living in these regions are often economically disadvantaged and far from a hospital. As a result, death by heart disease as well as cancer, unintentional injuries, chronic lower respiratory disease and stroke are more likely compared to urban residents.
And as the second-most rural state in the country, it’s a phenomenon with which North Carolina is familiar.
“We’re trying to fill (gaps) and provide a more optimal periprocedural home and all those pieces of health care that should be there,” Lobdell says. “And this is really the way we think it can be done — with this remote monitoring.”
Program leaders are selecting participants based on their barriers to accessing health care as well as risk factors. Nearly 10,000 people will be impacted, Atrium estimates.
Perfect Care is in its earliest stages. Program leaders are currently searching for the highest-quality technology at the best value to be purchased within the year. The pilot will get underway at Carolinas Medical Center, Carolinas HealthCare System Pineville and Carolinas HealthCare System Northeast, and it will expand to three other major Atrium facilities in the second and third year.
The pilot is being implemented by Atrium’s Sanger Heart and Vascular Institute as it focuses on cardiovascular care, since that area already has models and databases that can serve as benchmarks, Lobdell says. In the U.S., heart disease affects 11.5% of adults and is the No. 1 cause of death.
Program leaders hope this idea will one day benefit all areas of care.
“We would scale this to things like general surgery, orthopedics, neurosurgery, cancer surgery, so this newway of delivering care is just theway we deliver care,” Lobdell says.
Perfect Care is the only integrative cardiovascular care model of its kind; however, the program is a collection and expansion of the telemedicine capabilities already offered by Atrium Health, formerly Carolinas HealthCare System.
One of those is the MyCarolinas Tracker. The app lets patients upload data from their various devices, including exercise trackers, blood pressure cuffs, scales, heart rate monitors and thermometers. All that information compiles in one place and also in Atrium’s system.
Other forms include virtual visits, electronic ICU and the remote monitoring that is already occurring within hospital walls.
“We’re trying to aggregate a number of these innovative methods into one high-demand area, and that is cardiovascular services,” Lobdell says.
The Duke Endowment grant will be given in three segments over the three years. It’s the largest donation the Atrium Health Foundation has ever received from the private foundation. The two have a partnership spanning three-plus decades.
“One of the things we’re interested in is to understand the impact of the program because oftentimes it’s the follow-up care and the rehabilitation that’s done after a heart procedure that’s really important in terms of realizing clinical improvement and being able to sustain that improvement over time,” says Lin Hollowell, director of the foundation’s health-care program area.
“We see this as an opportunity for impact that is way beyond the three hospitals where they’re going to pilot the work,” he adds.
The Duke Endowment is Charlotte’s largest foundation in terms of assets at $3.35 billion as of the last fiscal year. It’s the third largest in terms of giving, with a total of $122 million at the end of 2015. It donates to nonprofit health-care and child-care institutions in the Carolinas; rural United Methodist churches; and Duke, Furman and Johnson C. Smith universities as well as Davidson College.