Daan Dohmen
FocusCura, Netherlands
Title: cVitals “Telemonitoring-as-a-service†concept for patients with COPD, heartfailure and/ or severe hypertension showing impressive outcomes leading to full reimbursement by mayor insurers in the netherlands
Biography
Biography: Daan Dohmen
Abstract
In Netherlands, both COPD and cardiovascular diseases are amongst the major drivers of overcrowded emergency rooms and increase of healthcare expenditure. Telemonitoring is seen as an important means to reduce the burden for chronic patients as well as to prevent EMR visits, hospital admissions and outpatient clinic visits; but large-scale implementations and reimbursement by insurers are scarce. Therefore, in 2016 mayor insurers in the Netherlands started reimbursing cVitals telemonitoring as a service concept in two important value-based healthcare projects. The first concept, ‘Heartguard’, focused on patients with heart failure and severe hypertension and was carried out in specialized focus-clinics of cardiology center in Netherlands. The second concept, ‘In Sight’, was carried out in the Slingeland Hospital together with homecare organization with sincere focus on patients with COPD and heart failure. In both concepts, patients are enrolled in a special cVitals telemonitoring as a service program which guides the patients through their individualized regimen, doing measurements at home such as blood pressure, weight and heart rate and sending them to their cardiologists. If any of the measurements deviates from the normal and/or the system finds an increased risk based on data-analysis, the health care provider receives an alert which can be followed by a video consultation intervention. Home or outpatient clinic visits only are done when needed. The services are contracted by mayor insurers in Netherlands using special reimbursement contracts, based on the foundation of value-based-healthcare and Triple Aim. The first results show that patients, who are using the service, need fewer interactions with their care professionals, outpatient clinic visits are reduced while patients are reporting significantly higher PROMS (EQ-5D, PAM-13). Also, less admissions and EMR visits are registered. Patients with the ‘Heartguard’ service showed an average decrease in blood pressure from 157/89 mmHg to 132/84 mmHg whereas 64% of patients with resistant hypertension gained control of their blood pressure within 3-6 months. These patients were referred by their general practitioners after various medicines failed to lower their blood pressure.