Medtronic’s moves in post-acute cardiac care management, monitoring

Medical device giant (and inverted to Dublin) Medtronic announced today the launch of their Beacon Heart Failure Management Service in the US. It combines their implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) devices with post-acute patient monitoring from Medtronic Care Management Services (MCMS). The patients are checked both through their recorded cardiac device diagnostics and what they called ‘branching logic’ questions which collect daily qualitative, biometric and symptom information, plus provide patient education. Care managers then review the data along what they term ‘established clinical pathways’ check for growing risk factors and alert providers if needed.

What is interesting is that the in-home delivery and collection platform or hub is not specified. Medtronic happens to own one of the telehealth pioneers, a company which used to be called Cardiocom–which is now part of Medtronic Care Management Services in their Cardiac and Vascular Group (CVG).

No launch clients/partners are mentioned, save a quote from a cardiologist at The Stern Cardiovascular Foundation in the Memphis TN area. ReleaseFierceMedicalDevices

In other Medtronic news, earlier this week they announced the acquisition of cardiac device company HeartWare for $1.1 billion. HeartWare has developed small implantable (more…)

AstraZeneca awards over $200k for heart failure telehealth

AstraZeneca Healthcare Foundation, the charitable arm of the UK based pharmaceutical company AstraZeneca, has awarded $205,564 to HSHS St. John’s Hospital in Illinois to support their Tele-Heart Pathway programme. [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/02/HSHS.jpg” thumb_width=”150″ /]The programme provides interventions to heart failure patients in their homes to support health management. With telemedicine and telehealth technology doctors monitor symptoms and help avoid complications at home after surgery, according to the hospital.

 “We have seen a rapid evolution in the last few years of new devices and new ways of communicating with our patients,” said Mark Stampehl, MD and Medical Director of the heart failure programme at Prairie Heart Institute (PHI) at St. John’s Hospital, in an article entitled Telemedicine elevates care for heart patients published in the fall 2014 issue of the hospital’s quarterly magazine Healthy You. “Today, we are using tools to remotely monitor a patient’s condition and increase communication with other physicians to give patients access to specialty care from home.” (more…)

4 year telehealth study charts ~40 percent CHF readmissions reduction

Finally an encouraging long-term, large N study on telehealth reducing same-cause hospital readmissions. Pennsylvania’s Geisinger Health Plan, the managed care arm of integrated health system Geisinger Health, has released findings from a four-year (2008-2012) study of 541 GHP Medicare Advantage beneficiaries with congestive heart failure. Hospital readmissions after 30 days were 44 percent lower and after 90 days 38 percent lower. Return on investment: “for every $1 spent to implement this program, there was approximately $3.30 return on this investment in terms of the cost savings accrued to GHP.”

Patients were assigned case managers and provided with a relatively simple program combining Bluetooth-connected weight scales and interactive voice response (IVR) calls to answer questions such as shortness of breath, swelling, appetite and on prescription medication management. The case managers used a platform to aggregate the data (more…)

Cigna, Care Innovations expand Tennessee CHF care management pilot

Healthcare payer Cigna’s Healthspring Medicare plan unit has been piloting a congestive heart failure (CHF) care management program with Intel-GE Care Innovations in Tennessee to reduce same-cause hospital  readmissions. The initial year-long 50-patient program is being expanded to 250 patients who have had a CHF diagnosis plus a previous ER visit or hospital admission. Patients are supplied at no cost a blood pressure cuff, a scale and the Care Innovations Guide on a tablet platform. Daily biometrics are sent to Cigna-HealthSpring nurse practitioners, and also complete an educational program to help them manage their CHF at home. After a 90-day minimum, once certain goals (e.g. weight loss, blood pressure and heart rate) are met, the patients stay in the program, the tablet is withdrawn but they continue to monitor and log their vitals with a case manager. What is curious about this seemingly anodyne (more…)

Medtronic and Aetna: the good and bad implications

A break in the ‘Perpetual Battle of Stalingrad’ that is also a Pointer to the Big2Big Future

Last week US insurance giant Aetna announced a partnership with medical device Gargantua Medtronic to pilot a program for uncontrolled Type 2 diabetes. Aetna will use claims data to identify 300 members who meet candidate standards for insulin pump therapy, Medtronic will reach out to them through their physicians to enroll them in the Getting2Goal program–as long as the insulin pump is Medtronic’s. The two-year program’s metrics will evaluate overall health outcomes and medical costs such as reduced ER and hospital stays. This is a fairly solid, albeit small N program for both. Other Aetna/Medtronic partnerships are a program for congestive heart failure (CHF) detection announced at HIMSS14, where Aetna plans to monitor device data to track the extra water retention that is usually an indicator of progressing heart failure; and an implanted glucometer program to monitor insulin levels for diabetics to avoid hypoglycemia.

Is this a Pointer to a Limited Future for Small, Innovative Independent Companies? Is this now signalling the US’s Big Payers only want to deal with Big Medical Device? “Value-based arrangements with companies like Medtronic” (release) make it ‘one-stop shopping’ for payers when it comes to physician relationships, IT implementation, data sharing and analysis. Will the end result be that payers stifle the revenue opportunity for small to midsize innovators by saying ‘don’t bother to knock”? Are these financially and technologically the best solution for the patient and for outcomes? (It’s like specifying only one hip or knee implant for all, and may sound familiar to our UK readers who have been following our recent articles on a certain telecare provider.) Aetna release, MassDevice, MedCityNews