Telemetric care of patients suffering from chronic heart failure with special reference to the telemetric care and education program "Telemedizin furs Herz" ("Telemedicine for the heart")

Chronic heart failure (CHF) is one of the most common diagnoses in internal medicine. It frequently results in a considerable loss of patient quality of life and is affected by improvable deficits regarding managed care, diagnosis, and treatment. Integrated care conceptions with telemetric support for persons concerned have proven to ameliorate the mentioned deficits. Apart from the resulting medical benefits, another significant advantage of such approaches is a reduction of costs of treatment and care for CH F patients due to a decrease in hospitalizations, which account for the better part of total costs. In this context the non-profit-making German foundation for chronic heart cases ("Deutsche Stiftung fur chronisch Herzkranke") has, in cooperation with the statutory health insurance "Techniker Krankenkasse", developed an integrated, telemetric care and education program for patients suffering from CHF. Since January 2006,the conception stands open to all insurants of the participating health insurance. A growing number of patients, momentarily 431, has been inscribed and takes advantage of this program. The 27-month program seeks for integration of all participating health-care providers. Patients are, by frequent nurse-mediated telephone contact under supervision of physicians, intensely and individually cared for. Throughout the program all patients take advantage of repetitive teaching regarding individually relevant aspects of CHF. Subject to the severity of their condition, the patients are, with telemetric support, motivated to implement daily self-measurements of weight, blood pressure and pulse into their everyday life. In the course of every telephone contact greatest care is given to convey knowledge about limit values of measured parameters and symptoms of decompensation on the basis of the acquired data. Participating practicing physicians are regularly informed about the progress of their patients and, if necessary, encouraged to enhance adequate, guideline- and evidence-based pharmacological therapy. By means of interaction of all these program features and subject matters, patients are, beyond the end of the program, empowered to enduringly and self-dependently deal with their chronic disease. Intermediate data suggest that participation of CHF patients in the depicted program is, among other effects, able to decrease hospitalizations, optimize treatment, increase quality of life, and decrease mortality.