Remote monitoring of pacemaker patients

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St. Mary’s General Hospital in Kitchener is the first Ontario hospital to offer a satellite location for pacemaker patients to perform device checkups remotely. This has the potential to significantly reduce patient travel time and expense, while ensuring their pacemakers are operating properly. The hospital operates a tier one Regional Cardiac Care Centre, which offers a full range of cardiac services to residents of Waterloo-Wellington Region and beyond.

The first group of patients completed their pacemaker device checkups at the YMCA-YWCA in Guelph, Ontario in late May. This was after months of research, planning and screening of potential St. Mary’s patients. The YMCA-YWCA has been a key partner in bringing this service to patients and allowing St. Mary’s to work within the community at a convenient and accessible location which enhances the patient experience.

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At the satellite location, a small group of eligible patients had their Medtronic pacemaker devices checked with the support of a representative from St. Mary’s and by holding a Medtronic Carelink Express® monitor antenna over the patient’s implanted cardiac device for two to five minutes. The data from the pacemaker device is instantly and securely transmitted over the telephone lines to secure servers owned and operated by Medtronic Inc. Within minutes the transmission data is viewable by the device clinic staff at St. Mary’s which is 30 kilometers away. Device performance and diagnostic data transmitted from the pacemaker is scheduled to be read within 24 hours by St. Mary’s staff. Any concerns with the information received, is communicated directly to the patient and follow up appointment at St. Mary’s may be requested.

Some pacemaker patients and their caregivers previously travelled up to 1.5 hours to have their device checked at the hospital. This new service allows those who are deemed eligible to have every second device check performed at a location closer to their homes. The recommended interval between device checks varies from patient to patient. A key aspect of the project is identifying patients who would most benefit from the service because they require more frequent checks.

Remote checkups do not take the place of care and health monitoring required by a family practitioner and at this point the technology is limited to specific pacemaker devices, manufactured by Medtronic and compatible with Medtronic’s CareLink Express® technology.

St. Mary’s has provided Medtronic CareLink home monitors to a small number of pacemaker patients for some time on an in-home and single patient basis for patients who can’t travel even a short distance for health reasons. However, St. Mary’s is the first hospital in Ontario, and only second in Canada, to use Medtronic’s CareLink Express technology to set up a service model for multi-patient transmission of pacemaker data from a remote monitoring satellite location to a cardiac centre.

St. Mary’s chose Guelph as the first satellite location for this pilot project because the timing of the availability of this technology combined with the recent transition of Guelph pacemaker patients to St. Mary’s created an appropriate group for this project. For now, remote monitoring in Guelph will be scheduled once a month. If successful, the service could be extended to other outlying areas served by St. Mary’s.

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“At St. Mary’s we strive to ensure that all patients in the region have convenient access to the most advanced cardiac care,” says Dr. Claus Rinne, a Cardiologist at St. Mary’s. “We hope that this project helps us to learn about a new way to provide seamless care that enhances the overall patient experience.”

Health care organizations in the United States, Australia, New Zealand and Europe and a site in Quebec are currently using this technology to offer broad remote pacemaker monitoring. In order to evaluate the success of the project, St. Mary’s collected baseline information which will be used to evaluate key performance indicators during the pilot, such as the patient experience and resource use.

“St. Mary’s is proud of its cardiac excellence and we are always looking for new and innovative ways to improve patient care,” says St. Mary’s President Don Shilton. “After extensive research and discussions with industry and government partners, we determined that remote monitoring technology has evolved in Canada to the point where it can now be a safe, viable and highly beneficial option for many pacemaker patients in our community.”