Weill-Cornell Testing Telemedicine Approach to Follow-Up for Heart Failure Patients
Researchers at Weill Cornell Medicine are testing different strategies to improve follow-up care for people with heart failure after being discharged from the hospital. The study will compare telemedicine to provide follow-up care at home to phone calls to assess patients’ health and connect them to social services as needed.
Heart failure causes a substantial burden on both health systems and patients because of preventable hospital admissions. Patients with heart failure are frequently hospitalized to help control some of the most common symptoms including shortness of breath, fatigue, and swelling of the feet. One week after getting discharged from the hospital, 40 percent of heart failure patients still report burdensome symptoms, and 25 percent of patients will return to the hospital within 30 days of being discharged.
Though studies suggest that patients should follow up with their healthcare providers soon after discharge, low appointment availability, transportation to clinics, and limited ability of patients and caregivers to administer needed medical therapies have prevented many patients from receiving proactive management that can improve patient outcomes.
The board of the Patient-Centered Outcomes Research Institute (PCORI) recently approved $4.2 million in funding for the three-year Weill-Cornell study whose purpose is to reduce hospital readmissions and symptom burden and improve the quality of care that heart failure patients receive after discharge from the hospital.
The project will compare a Mobile Integrated Health (MIH) intervention to a transitions of care coordinator (TCC). MIH leverages paramedics in the community and telemedicine (technology-enabled communication for health purposes) to provide medical care to heart failure patients in the home. The TCC group will receive a follow-up phone call shortly after discharge in which the patient is assessed and connected to clinical and social services as needed and patient education is reinforced. Patients will be randomly assigned to receive either MIH or TCC.
Principal investigators for the study are Rainu Kaushal, M.D., M.P.H., chair of the Department of Healthcare Policy and Research, Executive Director of the Center for Healthcare Informatics and Policy (CHiP) at Weill Cornell Medical Center, and Ruth Masterson Creber, Ph.D., R.N., an assistant professor of healthcare policy and research in the Division of Health Informatics in the Department of Healthcare Policy and Research at Weill Cornell Medicine.
They will compare the effectiveness of MIH to TCC on preventable healthcare utilization (hospitalizations at 30 days, emergency room visits); healthcare quality (days at home, prescribed specific medications); and patient-reported outcomes (quality of life, symptoms).
The study population will include a diverse mix of patients who have a diagnosis of heart failure, speak English or Spanish, are 65 years and older, and primarily receive their health care at the NewYork-Presbyterian or Mount Sinai health systems. These patients will be recruited and enrolled during their hospitalization, prior to discharge to home.
