The Challenge

Rates of patient adherence to in-person cardiac rehab programs are generally low, largely due to the inconvenience of having to travel frequently to a rehabilitation center and coordinate sessions with the care team. This was no different at Sheba Medical Center where there was limited care team capacity and no hospital-to-home continuity of care plans in place. With the logistical burden of travel to and from the care center, patient adherence was under 30%. A combination of these challenges led to insufficient data on activity and wellbeing for their CHF, post-cardiac surgery, and post-ACS patients. The goals of the program were to improve cardiac rehabilitation, optimize medication management, create workflow efficiencies and provide the proper education to patients while proving the safety of the remote care program- all of which led to improved outcomes.

The Solution

Implementing Datos Health’s remote patient management platform to capture and analyze patient vitals provided valuable insight to both the patients and the care team. The Datos Health platform is device-agnostic which allows care teams to choose which medical device or fitness tracker works best within their workflow to easily track vitals such as blood pressure, heart rate and weight as well as workouts, steps and sleep. Additionally, providers gained the ability to intervene in real-time if a patients measurements fell outside of normal range and they were able to asynchronously monitor their patients’ exercise plans and progress. In this program, patients were given the freedom to use any fitness tracker or smart watch they already owned and used which led to increased patient adherence and a clearer view of patients’ conditions, activity and progress between in-person visits.

The versatility of datos’ remote care platform and its ability to increase patient engagement and adherence through personalization of the application is integral to making tele-cardiac rehabilitation a viable option for patients unable or unwilling to participate in center-based cardiac rehabilitation programs.

– Prof. Robert Klempfner, MD, Director of the israeli center for cardiovascular research
and scientific director of the ARC innovation center at Sheba Medical Center

Datos Health’s Care Pathways Design Studio features a no-code drag and drop interface, allowing the team at Sheba Medical Center to quickly and easily deploy personalized remote care workflows to best fit their patients’ needs. Based on rules defined by the care team, the Datos Health software follows a decision- tree to prompt actions for either the patient or the
care team. Vitals measurements and other patient health data collected from devices and through survey responses from validated questionnaires such as PHQ9 and PROMIS10 are aggregated and scored using the Borg rating. Based on the score, automated triggers either guide patients through assisted self-care or alerts the care team that intervention is needed. The proactive management of patient health through automated workflows determining if treatment or medication changes are needed helps reduce the care team workload allowing them to focus on patients that need them most. They are able to provide assistance to the rest of their patients in real-time and all of their patients benefit from customized care plans. Patients are connected to their care team through robust communication engines on the Datos Health platform which facilitates video visits, appointment scheduling, and messaging directly through the app. Care teams can also send automated reminders to their patients to answer surveys, schedule an appointment or take or discontinue medication.

Benefits

Cardiac rehabilitation significantly improves outcomes following a cardiac event. Datos Health’s remote care platform helped Sheba Medical Center considerably improve patient adherence and increase their capacity.

For every 100 cardiac rehab and CHF patients in their program 0.5 exercise specialist, 0.33 RN, 0.2 cardiologist, and 0.25 physiologist were needed. The greater insight into patient health provided to the care team led to an approximate 40% increase in patients that met recommended therapy (ARNI, SGLT2i, Beta B., MRA) at the target dose, and more than 80% of patients adhered to the program based on ESC guidelines for diagnosis and treatment.

Allowing patients to exercise whenever and wherever is convenient for them led to a significant improvement in exercise capacity of approximately 1.5 METs. Overall, Datos Health’s personalized, automated remote cardiac care platform helped to significantly increase adherence and program completion, which, in turn, has been shown to improve long-term patient outcomes and quality of life. Care teams gain back valuable time to focus on the patients who need it most by eliminating the need to synchronously accompany every patient workout. In addition, patient capacity can significantly increase by automating aspects of a clinical workflow with symptom surveys, medication reminders, and automated triage.