EXCLUSIVE: How telehealth can transform cardiovascular disease care for patients and clinicians

29 September marks World Heart Day, which aims to raise awareness around living with cardiovascular disease (CVD) and how looking after heart health can prevent more complex healthcare services being required.

Having cardiovascular disease can have significant physical and emotional impacts and can affect an individual’s thoughts, feelings, and daily lives.

Below Dawn Watson, Clinical Application Specialist Lead at Tunstall Healthcare, discusses how telehealth can transform CVD care for both patients and clinicians after the NHS Long Term Plan identified CVDs as ‘the single biggest area where the NHS can save lives over the next 10 years’.

Understanding the impact of CVD

Cardiovascular disease remains the UK’s, and the world’s, number one killer, according to the World Health Organization. There are a number of conditions associated with CVD including hypertension, heart failure, coronary heart disease, and abnormal heart rhythms (arrhythmia).

In addition to potentially causing significant ill health and a leading cause of death, CVD adds to NHS and social care workloads and costs and wider economic costs to society and loss of productivity. For example, social care for stroke survivors costs the UK economy £5.2 billion annually, and the overall health care costs of CVDs in England are estimated at £7.4 billion annually, with an annual cost to the wider economy of £15.8 billion. Reducing the prevalence and impact of CVDs can therefore significantly reduce health and care workloads and wider societal costs.

Many factors contribute to developing CVD; however, it is possible to reduce the risks and manage the aforementioned conditions with lifestyle choices, the support of a health and social care team, and integrating key pieces of technology.

How technology supports CVD patients and clinicians

Telehealth has been around for some years and the implementation of services continues to increase. The Covid-19 pandemic resulted in commissioners of services and professionals thinking differently about models of care delivery, looking for new ways to continue having contact with patients, and monitoring a variety of medical conditions including CVD.

As a result, the uptake of digital solutions has accelerated rapidly, enabling remote care and reducing the risk of infection for patients and healthcare teams alike. Technology enables patients to monitor their medical condition at home, using technology to share information to their health and care team; this includes monitoring blood pressure, oxygen levels, and weight.

Patients work with their practitioners who, with the support of technology providers such as Tunstall Healthcare, can develop a tailored health programme to suit their patients’ needs by helping them maintain or improve their medical condition and understand it better.

Through using technology, citizens receive the support they need to better understand how their condition affects their daily lives. A patient’s direct involvement in monitoring their CVD allows them to build confidence, maintain their independence, and make informed decisions about their health. Technology can support people to manage their heart failure at home, helping them to understand the effects of their behaviour on their health, and stabilise their condition. It can also enable any deterioration in health to be identified and treated at an early stage, avoiding the need for more complex interventions.

For practitioners and clinicians, telehealth enables them to detect any changes in a patient’s condition at an early stage and adjust the treatment plan accordingly before their condition worsens. This reduces anxiety and distress for the patient and can eliminate the need for an urgent appointment, home visit, or admission to hospital.

Technology in practice

Ceredigion Community Heart Failure team, Delta Wellbeing, Hywel Dda University Health Board, and Tunstall Healthcare have worked together to deliver a telehealth package to support heart failure patients in their own homes.

Patients are enrolled onto service by Health Care Support Worker (HCSW), and Llesiant Delta Wellbeing arranges system installation and training directly with patients. Patients then take their own vital signs readings, such as blood pressure, weight, and pulse oximetry at home. Tunstall provided comprehensive, specialist training for the Heart Failure Team, contributing to pathway planning and ensuring a smooth transition to the new model of care.

A range of materials were also created to support patients in learning about the service, as well as them receiving a tutorial on how to use the equipment at the point of installation. In addition to the standard telehealth heart failure clinic, ‘one stop’ weekly clinics have also been introduced which prioritise patients with reduced ventricular systolic function, according to their at-home diagnostic screening tools.

Across both the heart failure clinics, more than 100 patients have used the service (as of September 2023), and patients report improved self-management and resulting health improvements, including avoiding an admission to hospital. Hywel Dda covers a rural area, and remote health monitoring also helps to improve access to care due to the decreased need for travel.