Kaiser Permanente has demonstrated promising results in reducing secondary cardiac events and rehospitalizations by creating a virtual cardiac rehabilitation program that fits seamlessly into patients’ lives. Increasing rates of program enrollment and completion have key factors in the improved outcomes. Results and details about the program were publish today in NEJM Catalyst.
Cardiovascular disease is the leading cause of death in the United States . While cardiac rehabilitation programs prescribed exercise and diet, as well as health education and counseling can significantly reduce the risks related to cardiovascular disease; few cardiac patients enroll in rehabilitation programs, and even fewer complete them .
Kaiser Permanente’s virtual cardiac rehabilitation program; develop in collaboration with Samsung; combines wearable technology with support from an assigned health care team. The program has enrolled more than 2,300 patients; making Kaiser Permanente’s virtual cardiac rehabilitation program one of the largest in the U.S. More than 80% of the patients who have join the program complete it, compared to the national average of less than 50%.
Hospital readmissions for patients
Cardiac relate hospital readmissions for patients in Kaiser Permanente’s program have been less than 2%, compare to 10-15% average for most programs. “Knowing that lifestyle change plays such a critical role in the long-term health of cardiac patients; they set out to find a way to make the rehabilitation program as easy and seamless as possible for our members,” said Tad Funahashi, MD, who leads clinical innovation at Kaiser Permanente in Southern California.
“By working closely with patients, care providers; also case managers we were able to do just that. Our virtual cardiac rehabilitation program is proving to keep patients engage and reduce readmissions.” The Kaiser Permanente program has graduate 1,880 patients since 2018. Clinicians anticipate serving the needs of more than 5,000 patients in 2019.
“Weekly contact with the nurse provide tremendous reassurance for me,” said Michelle Wofford, 42, a Kaiser Permanente member who enrolled in the program after she had a stent place to open a blockage in a coronary artery. “In addition to using the watch and smartphone app to stay on track with my physical activity. They also had access to a nutrition class. The Plants for Life class was life-changing and emotional for me because realize that need to change my diet to avoid going down a path I could not come back from.”
Virtual cardiac rehabilitation
Patients are encouraged to enroll in the eight-week virtual cardiac rehabilitation program. Once enroll patients meet with their care team to create a rehabilitation program specific to their unique needs. They use a Samsung smartwatch that pairs via Bluetooth with an Apple or Android smartphone. The watch sends reminders to the patient to exercise; collects patient activity data and continuously displays the patient heart rate during exercise.
This data is automatically uploaded via the smartphone into the patient’s chart so that clinicians; case managers and physical therapists can track patient progress and engage with them accordingly. Using the smartphone and Kaiser Permanente’s existing digital platform; patients meet virtually with a care manager once a week to discuss their progress and learn about lifestyle modification; which as it relates to their own unique needs. They can also contact a care manager for an immediate response to concerns about symptoms or medications.
“The clinical benefits of regular meetings with and 24/7 access to the care team are two-fold: Care providers foster stronger relationships with patients due to additional touch-points, and patients receive a more holistic treatment plan with wraparound services such as wellness coaching and counseling,” said Columbus Batiste, MD. “However, for many patients, the most rewarding aspect of virtual cardiac rehab was having ownership over their health. By tracking progress, patients became invest in their care.”