Internet-based Telemedicine for Cardiovascular Disease Management - PowerPoint PPT Presentation

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Internet-based Telemedicine for Cardiovascular Disease Management

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  1. Internet-based Telemedicine for Cardiovascular Disease Management Alfred A. Bove, MD, PhD Cardiology Section Temple University Medical Center

  2. Why Telemedicine? • Shift in incidence from acute to chronic disease • Heart Failure • Hypertension • Diabetes • Respiratory Disease • Renal Disease

  3. New Concepts Toward a National Health Information Infrastructure June 2000 National Committee on Vital and Health Statistics

  4. Heart Failure Demographics • Heart Failure patients The graph shows an increasing incidence of heart failure patients from 1970 to 2040

  5. Telephone Surveillance 47 pts 20 mos Chrysogelos E et.al . J Card Fail. 2000; 6:II-6. The graph shows a reduction in hospitalization and ED visits in heart failure patients using a telephone surveillance system.

  6. Telehealth System The diagram shows the connections between the patient, provider and information database via the internet for communications.

  7. Patient Management The figure shows a screen from the Internet communication system used for hypertension management

  8. 48 pts 12 mos P = 0.025 The graph shows a reduction in hospital days in patients with heart failure who used our Internet communication system. Kashem at al. J. Cardiac Failure 2008

  9. CVD Risk • High in Underserved populations • Inadequate care availability • Inadequate health education • The “Medical Divide” • Increased Obesity/Metabolic Syndrome

  10. CVD Risk Management • Record Risk Factors The figure shows a web screen used for cardiovascular risk management

  11. Patient Management • Provide longitudinal feedback The figure shows a web screen used for cardiovascular risk management

  12. Risk Factors • Rural vs. Urban This slide shows the distribution of risk factors in urban and rural subjects

  13. Clinical vs. Telemedicine • Blood Lipids * * * * This slide shows the changes in blood lipids in subjects using the telemedicine system compared to a control group

  14. Clinical vs. Telemedicine • Systolic Blood Pressure * * This slide shows the changes in systolic blood pressure in subjects using the telemedicine system compared to a control group

  15. Clinical vs. Telemedicine This slide shows the time course of changes in systolic blood pressure over a one year period in subjects using the telemedicine system compared to a control group

  16. Clinical vs. Telemedicine * * This slide shows the changes in CVD risk score in subjects using the telemedicine system compared to a control group

  17. Managing Hypertension • Over 65 million patients • Most not at goal BP • Problem with medication adherence • Increased risk: • Heart disease • Stroke • Renal failure

  18. Patient Centered Therapy • Knowledge • Goal BP (guideline-based) • Lifestyle effects • Diet effects • Medication effects • Surveillance • Self measured BP • Weekly reporting • Communication • Internet • Telephone

  19. Patient Centered Therapy • Reporting • Patient - monthly summaries via mail • Physician - monthly summaries via fax • Quality • Education • BP goal • Lifestyle changes • Medication appropriateness

  20. Internet Use This slide shows a web screen used for our Internet-based hypertension management system

  21. Internet Use This slide shows a web screen used for our Internet-based hypertension management system

  22. CLINIC HOSPITAL PHARMACY PATIENT INTERNET PATIENT SERVER WIRELESS PROVIDER Information Infrastructure INFORMATION CENTER This slide shows the new configuration of our Internet-based hypertension management system, and future concepts for health information

  23. What Works for Telemedicine • Chronic Illness • Patient participation • Care team includes the patient • Home monitored status • Hypertension • Heart Failure • Diabetes • COPD/Asthma • Easy Communication • Expectation/empowerment