Implementing remote monitoring for cardiac patients

OTTAWA – CADTH (Canadian Agency for Drugs and Technologies in Health) has published new recommendations that offer advice to pan-Canadian health systems on how to implement remote monitoring programs for patients with chronic cardiac conditions. These recommendations emphasize patient, caregiver, and provider considerations, data and privacy, digital equity, and evaluation.

Remote patient monitoring programs are a form of virtual care that allows patients to be examined at a distance instead of in a hospital or clinic setting. Patients are consulted via telephone calls and/or video conferencing, and the patient’s health data can be exchanged by stand-alone devices or other digital platforms. The focus of these recommendations is on the use of remote monitoring programs for patients with heart failure, atrial fibrillation, or hypertension, or for those who are participating in cardiac rehabilitation. Monitoring conducted via implantable cardiac devices was outside the scope of this work.

Millions of Canadians live with chronic cardiac conditions, but remote monitoring programs for these patients vary greatly across the country. The needs of jurisdictional health systems to successfully implement these programs also vary significantly and depend on the operational infrastructure and technology platforms they may have adopted.

The CADTH Health Technology Expert Review Panel (HTERP) developed these forward-looking recommendations to offer guidance on the design and implementation of remote monitoring programs. The recommendations address key program characteristics, including:

• flexibility to adapt to patient circumstances and preferences
• integration into care pathways for chronic cardiac conditions, with policies and processes to support the process (including alignment with clinical practice guidelines and integration into electronic medical records)
• transparency about data flow and patient privacy
• awareness of underlying barriers that could create or exacerbate inequities in care
• evaluation to ensure that multifaceted program goals are met.

Expanding virtual care in Canada has been a top priority of federal, provincial, and territorial governments since the start of the pandemic, and remote patient monitoring tools have been identified as one of their five shared priority areas for investment.

“The pandemic has been a turning point for remote monitoring programs but the uptake across Canada remains fragmented and inconsistent,” says Lesley Dunfield (pictured), vice-president of Medical Devices and Clinical Interventions at CADTH. “CADTH’s recommendations come at a pivotal time for our health systems. Decision-makers are looking for evidence-informed guidance on how to both sustain and advance the use of remote monitoring to improve patient outcomes and make healthcare services more accessible to patients.”

The expert recommendations were informed by two CADTH reports published earlier this year, including an Environmental Scan and a Health Technology Assessment (HTA).

Draft versions of the project protocol, evidence reports, and recommendations were publicly posted for stakeholder feedback before finalization.

About CADTH
CADTH is an independent, not-for-profit agency funded by Canadian federal, provincial, and territorial governments to provide credible, impartial advice and evidence-based information about the effectiveness of drugs and other health technologies to Canadian healthcare decision-makers.