Expert Consensus Statement and Remote Patient Monitoring Guidelines

What does the Heart Rhythm Society’s new Expert Consensus Statement say?

The Heart Rhythm Society recently unveiled the new 2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic, marking significant progress since the previous 2015 version, which originally identified remote monitoring as the standard of care for implantable cardiac device clinics. 

The statement marks notable shifts in the remote patient monitoring landscape that required adjustments to guidelines regarding:

• Increases in patient volume
• Escalating alert frequencies
• Heightened willingness from patients to embrace and trust remote monitoring

The updated expert consensus statement was met with considerable enthusiasm when it was presented at the Heart Rhythm Society’s Annual Meeting, acknowledging both the benefits and the challenges that remote monitoring presents to device clinics. This edition emphasizes the importance of a “team” approach to remote monitoring success, requiring the cooperation of all stakeholders – physicians, device technicians, administration, industry representatives, patients, and caregivers. 

What does this mean for cardiac device clinics?

We at Vector are thrilled to continue our contribution to the team effort to support clinics in their journey to improve outcomes for cardiac device patients. We understand the necessary elements needed to ensure success in a cardiac device clinic and are encouraged by the emphasis these remote patient monitoring guidelines place on adequate staffing, patient engagement, and data management.

Here are a few of the most important key takeaways from the Heart Rhythm Society’s presentation of the Expert Consensus Statement:

Staffing

The new consensus statement suggests a staff-to-patient ratio of 3:1000, including clinical and non-clinical personnel. This recommendation was met with applause when announced by Brynn E. Dechert-Crooks, APN. Another crucial point is that 27-40% of alerts are unscheduled, requiring significant time management and handling scheduled transmissions. Combining clinical and non-clinical staff with clearly delineated roles and responsibilities will foster efficient procedures and effective care.

Patient Connectivity

Continual patient connectivity is paramount and a fundamental aspect of the consensus statement. As Janet Han, MD, noted in her presentation, “An efficient remote monitoring clinic cannot exist unless your patients are connected.” Strategic patient education plays a vital role in enhancing connectivity. Empowering patients and caregivers with the necessary information and ensuring continuous communication can allow them to appreciate the value of maintaining connectivity.

Alert-based Remote Monitoring

Niraj Varma, MD, PhD shared in his presentation that 5% or less of appointment-based interrogations lead to actionable steps. The consensus statement suggests moving to a two-year requirement (previously annual) for in-clinic interrogations for pacemaker and ICD patients without any events or comorbidities who are compliant with remote monitoring. The consensus statement also promotes the use of alert-based remote monitoring to prioritize workload and manage only actionable alerts. Transitioning your device clinic’s interrogation model to “continuous monitoring” will reduce transmission volume and allow staff to focus on the most urgent alerts.

What should my clinic’s next steps be?

These guidelines make significant strides toward enhancing the value of remote monitoring, improving clinic efficiency, and improving patient outcomes. Connect with our team to learn more about how Vector Remote can help your clinic best meet these updated standards of care.