Home is where the best heart care is
30 April 2008
Joshua Rowe, chairman for telemedicine specialist Broomwell
Healthwatch, explains how a cardiac telemedicine service can improve
patient care whilst cutting the cost of congestive heart failure (CHF).
The cost of diagnosing, treating and caring for patients with cardiac
related problems represents the single largest financial burden on the
UK's National Health Service (NHS). The estimated cost of
cardiac care annually in the UK is over £34 billion , with the cost
to the taxpayer of treating cardiac A&E patients averaging at around
£305,000 per patient .
One cardiac condition impacting greatly on the NHS is congestive
heart failure (CHF). The total direct medical cost of this long-term
condition in the UK each year is currently just over £625 million ,
with hospital inpatient care of CHF being the biggest single healthcare
cost, accounting for approximately 60% of the total cost of CHF in the
This issue needs to be addressed. Conventional methods of treatment
aim to reduce symptoms and delay progression of the disease, reduce
hospitalisation and extend and improve the patient's quality of life.
However the ideal would be to deploy a method that not only monitors
and manages the symptoms of CHF but also significantly reduces its cost
to the NHS. Adopting a solution which has the ability to move treatment
away from hospital care to home care seems the best way to achieve this.
Home care cardiology
The average length of stay for a patient admitted to hospital with
CHF is over 13 days, three times the average length of stay for all
Detecting, diagnosing and treating cardiac symptoms at an earlier
stage will help prevent avoidable hospital admissions, thereby cutting
costs, freeing up resources in secondary care and allowing NHS resources
to be reallocated to other key areas. Early detection means patients
receive more timely and preventative support, therefore reducing the
need for hospitalisation; this not only benefits patients from a
clinical point of view, it also helps to alleviate the overall burden on
Broomwell Healthwatch has developed a telemedical solution for
monitoring and managing CHF from the patient’s own home. Our telemedical
weight scales and blood pressure monitor both detect early symptoms
associated with CHF, such as weight gain through fluid build-up and
increased blood pressure , allowing physicians to monitor patients’
progress, diagnose problems quickly and administer timely preventative
care, delaying progression of the disease and helping to save lives.
Typically CHF patients are expected to keep a diary of their weight
and visit their GP on a regular basis for an evaluation, but this method
relies heavily on the patient remembering to keep an up-to-date and
coherent record of information.
The weight scales and blood pressure monitor solution relieves
patients of this responsibility whilst giving monitoring clinicians a
more reliable and accurate result. It also transfers the responsibility
of detecting any significant changes from the GP to a cardiac clinician
trained specifically in this area of medicine.
Ultimately the clinical responsibility does rest with the patient’s
GP but this solution allows patients to have their weight and blood
pressure carefully monitored from the comfort and convenience of their
own home, meaning they avoid constant trips to the GP for routine
evaluations and unnecessary trips to hospital. This reduces stress for
the patient and reduces the operational and financial burden on the NHS.
The scales measure the patient’s weight and transmit the data
automatically to Broomwell’s monitoring centre via a home gateway unit.
Blood pressure readings are transmitted in a similar way. Cardiac
clinicians at the centre monitor the data for any potentially dangerous
trends or deviations from the set parameters, meaning prompt action can
be taken if needed.
On receipt of the data, clinicians at the monitoring centre are
automatically presented with the patient’s clinical records and medical
history. If any abnormalities are identified, the results are
transmitted to district nurses and / or the patient’s physician for
early intervention, or in more critical cases the patient is sent for
The obviously ill patients are easier to manage; these patients
receive prompt intervention, stabilisation and rapid referral to the
appropriate facility. The challenge begins with those patients who show
subtle signs and symptoms of a cardiovascular condition or CHF; this is
where the expert service is of most benefit.
Weighing up the benefits
Giving GPs access to fast expert advice on sometimes complex cardiac
issues is an invaluable aid and Broomwell’s studies suggest that home
monitoring of patients with CHF can save the NHS over £60 million each
year and save thousands of lives.
Our research shows that CHF-related hospital admissions account for
62,582 episodes per year, costing the NHS around £211 million annually.
By saving the NHS over £60 million a year, the CHF monitoring solutions
could free up 29% of the overall cost spent on CHF by the NHS per annum.
The service is great for both patients and the NHS. As well as
delivering financial benefits it will have a considerable impact on
diagnostic efficiency — contributing to achieving a higher level of
Cardiac telemedicine helps fast and accurate diagnoses to be made,
reassuring the majority of patients within their own homes that their
condition is stable, thus preventing unnecessary GP visits, whilst those
in immediate danger are transferred to hospital care.
A £60 million a year saving means the NHS could re-allocate funds to
other key areas and monitoring CHF at home would lessen the operational
burden on GPs and hospitals, freeing-up resources. The service has the
potential to make a huge difference to the NHS whilst saving the lives
of thousands of patients.
The technology has already been rolled out across a major city
primary care trust to help monitor and diagnose CHF and has had positive
Cardiac telemedicine has brought the expertise of leading
cardiologists straight into the homes of CHF patients. This proactive,
preventative approach not only provides a more effective model of care
for cardiac patients, but also helps ensure NHS resources are optimised
and used as effectively as possible.
Joshua Rowe, Chairman of Broomwell Healthwatch.
1. British Heart Foundation Statistics Database, 2006,
2. Dr Foster Intelligence
3. British Heart Foundation Statistics Database, 2006
4. British Heart Foundation Statistics Database, 2006
5. British Heart Foundation Statistics Database, 2006
6. NHS Direct website: