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Internist (Berl). 2019 Apr;60(4):331-338. doi: 10.1007/s00108-019-0570-2.

[Telemedicine in heart failure].

[Article in German]

Author information

1
CharitéCentrum 11 für Herz‑, Kreislauf- und Gefäßmedizin, Medizinische Klinik und Poliklinik mit Schwerpunkt Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. friedrich.koehler@charite.de.
2
CharitéCentrum 11 für Herz‑, Kreislauf- und Gefäßmedizin, Medizinische Klinik und Poliklinik mit Schwerpunkt Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Abstract

Improved outpatient care of heart failure patients is considered crucial to avoiding unplanned cardiovascular hospitalizations and reducing mortality. Making up for regional and rural differences in heart failure care poses a further challenge. Telemedical care as a supplement to outpatient point-of-care medicine by the general practitioner and medical specialist is considered relevant to implementing this goal. This article presents the technical and organizational basics of telemedical methods in outpatient heart failure care. Current evidence on the efficacy of telemedical co-management is also explained based on the results from the nine most important randomized studies on telemedicine in heart failure. Particular attention is paid to the TIM-HF2 study published in 2018, which showed the superiority of telemedical co-management in terms of mortality and morbidity following recent hospitalization for heart failure. Pre-stratified subgroup analysis revealed no significant interactions in terms of the primary endpoint between urban and rural regions. Scalability is required in order to translate the telemedical study concept from TIM-HF2 to a nationwide care program for all patients in Germany. Telemed5000 is the first project to set its goal as the development of a telemedicine center for the telemedical co-management of up to 5000 patients using artificial intelligence. It is being funded by the Federal Ministry of Economics and Technology for the period 2019-2022.

KEYWORDS:

Call centers; Monitoring, outpatient, remote; Outpatient care; Standard care; Telemedicine center

PMID:
30820589
DOI:
10.1007/s00108-019-0570-2

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