Improving heart failure care by using a telemedicine system

Heart failure constitutes the most frequent and expensive hospital discharge diagnosis in the United States, costing annually over $10 billion. Optimal care requires an understanding of their illness, participating in clinical decisions, and frequent communication. Current surveillance is labor intensive and expensive. Follow-up is often inadequate, incomplete, and inconsistent. To address these problems, we developed an Internet-based telemedicine system, consisting of a secure server and database. Patients send or receive data to or from their care provider via the Internet. The system optimizes function and minimizes cost (all hardware is off the shelf and FDA approved). This paper describes our initial experience with this system. We are currently using this telemedicine system in a prospective, randomized clinical trial, comparing Class III or IV heart failure patients with standard care versus standard care plus telemedicine.