Advice on Patient Education and Remote Scheduling of Cardiac Implantable Devices
What is the best time and place for CIED remote monitoring patient education to occur?
Keith Nicholson, CCDS, PrepMD Business Operations Director pointed out that the best time for patient education to occur may be at the wound-check appointment:
“Post-op when the device is implanted, the patient has a great deal of information being thrown at them and it can be very overwhelming. Often, we find that at the wound check appointment the patient will be able to process information more effectively, especially if they are provided with helpful written documentation or FAQs to explain how their monitor works and what the frequency of transmissions will be.”
It’s most helpful also at this point if the patient can also be provided a phone number to the specific clinic representative who they can reach out to if they have questions or concerns while setting up their monitor at home.
Patients are oftentimes confused and afraid to ask questions, so having someone who will patiently address their concerns and walk them through setup can quickly result in compliance improvement. It helps to anticipate what the most common patient concerns are that will need to be addressed.
Is Vendor Technical Service Helpful for Troubleshooting? Some technical issues with the monitors can sometimes require more in-depth troubleshooting just to diagnose the issue. Patients may be confused if they have to deal with multiple individuals for help with their monitor. In this scenario the clinic may find their disconnection rate is occurring more quickly than their recovery rate.
Clinics can and should use the vendor technical service departments for assistance. In fact, Medtronic accepts requests for outgoing calls, where they will place outbound calls to patients to help them troubleshoot with real time instruction. With the other vendors who don’t place outbound calls to patients such as Boston Scientific, Biotronik, Abbott or Merlin, they are always happy to help patients who are calling in for help with reconnecting monitors.
Some patients are much more capable of self-help and other patients may not be technically savvy and may require more assistance. When a patient is directed to call the vendor to troubleshoot connectivity over the phone this can oftentimes be a great success. However, in some cases a breakdown can occur when the patient is asked to call the vendor and they either don’t follow through or don’t have success.
Remote Scheduling Best Practices
As far as remote scheduling, usually the best practice is to utilize the smart or automatically recurring schedules that exist within the device company websites. This often helps the patient education process, and the patient knows what to expect in terms of scheduled transmissions and copays. Smart scheduling is easily available under the scheduling tab on most vendor websites. Clinics should ideally always use the Smart Scheduling option to ensure coverage of their patient monitoring. Risks of not having patients scheduled include a potential for clinic liability. If a patient is connected but not scheduled the clinically actionable data could be missed. Even with Alerts optimized, summary transmissions sometimes demonstrate something that is clinically important.
Device clinic management is very complicated and each clinic is unique. The PrepMD Clinic Solutions Team provides solutions to help.