CardioMEMS - Reducing Hospitalizations and Saving Lives
The CardioMEMS system is a device implanted in the wall of the pulmonary artery. It requires no batteries or replaceable parts. It is capable of monitoring and assessing the pulmonary artery pressures and heart rate in patients with heart failure while improving their quality of life by reducing the need for hospital re-admission by delivering data through electronic media while the patient is at home.
Theresa Adair, RN, MBA, BSN, Director of Cardiovascular Services for Good Samaritan says there are a number of patients that can benefit from the device while also reducing the number of patients coming into the Emergency Department in heart failure, decreasing the frequency of office visits and saving millions on hospital re-admissions.
“This is a new tool to monitor patients and optimize their care while they are living their lives. It’s about quality of life for these patients,” says Adair.
Key to its success Adair adds, are four components: patient selection, patient education, a patient’s ability to comply; and his or her follow-up care. “Once we knew the device would be available we began identifying patients we believed could be candidates for the procedure. Mostly they are patients who are admitted frequently to the hospital for heart failure. This is intended to assist with avoiding re-admission.”
Good Samaritan currently has five physicians who are credentialed to perform the procedure: Paul Lee, MD, Ezra Deutsch, MD, Michael Happes, MD, Shahram Hormozi, MD, and David Reich, MD. Dr. Deutsch performed the first implantation in July.
There are strict criteria for patient selection but once a patient is identified as being a candidate for the device, Adair says education becomes vitally important. They are instructed on the procedure prior to the implantation so that they understand what will be involved. Compliance with monitoring their pressure is vital. Prior to discharge they are again instructed on use of the device and the necessity of complying with monitoring and readings. They are sent home with a pillow and transmitter.
Patients are instructed to lie on the pillow which includes a sensor that reads pressure measurements and wirelessly transmits that information to an external electronics unit accessible to clinicians for review. If pressure begins to rise the clinician, usually a nurse practitioner or physician’s assistant with comprehensive competency in CardioMEMS will contact the patients and adjust their medications accordingly.
Adair says, the closest point in which a heart failure problem begins is the pulmonary artery therefore, any issues that may be arising are caught at the earliest possible point with daily monitoring. “Like any problem you want to catch it at the point where it begins. This device can provide data, even before symptoms present. That gives us the best chance of preventing re-admittance of patients to the hospital.”
Adair says that Good Samaritan is anticipating 200 patients will be eligible for CardioMEMS this year and 200-400 next year. Patients who are on blood thinners are not candidates for the procedures.
Nationally, 5.1 million people have heart failure which requires re-admittance within six month after an incident. Costs are estimated at $31 billion annually and by 2030 are projected to more than double, costing each U.S. taxpayer $244 annually. The Centers for Medicare and Medicaid Services has listed reducing hospital re-admittance as a top initiative in cost cutting measures Adair says.
“The important thing is the number of patients we have that could benefit along with the benefit to the institution in the amount of dollars saved by of patients not returning to the Emergency Department as well as the patients’ quality of life. They are not coming in with full blown heart failure which puts them in a more vulnerable state.