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eHealth is a “new path in patient care that is not going to stop”

This year, EHRA EUROPACE - CARDIOSTIM is holding an eHealth Summit to meet the needs of the growing number of physicians with an interest in this area. This article will explore what eHealth means, its application in electrophysiology, and the topics of this year’s summit.

e-Health
e-Cardiology
Arrhythmias


In a position statement from the European Society of Cardiology (ESC), published in the European Heart Journal, Professor Martin R Cowie (National Heart & Lung Institute, Imperial College London, London, UK) and others reported that eHealth encompasses the use of “information and communication technologies in the support of health and health-related activity”. They add that it can be subdivided into various categories, from telemedicine and telecare “including disease management services, remote patient monitoring, teleconsultations, and homecare” to personalised health wearable technologies.

According to Cowie and his colleagues, patients are becoming increasingly familiar with eHealth and expect “to find it supporting modern healthcare delivery, facilitating a more personalised and more patient-centred care at the right time and in the right place”.

Professor Georg Schmidt (Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany) agrees, noting that physicians also have a growing interest in eHealth, which is why this year’s congress is holding a summit on the topic.

He said: “EHRA EUROPACE - CARDIOSTIM has always been focused on invasive electrophysiology; in other words, cardiac implantable electronic devices and ablation. Now, for the first time, we have organised a summit for people interested in eHealth.”

All three sessions of the summit will be held today in room Elmquist and will look, respectively, at remote monitoring, electronic health records, and wearable technologies. Regarding remote monitoring, Prof. Schmidt stated that the potential advantages were “earlier detection of problems” and this could lead to reduced costs because a more severe complication may be avoided. However, he added that the disadvantages included unspecific predictors that might trigger “unnecessary diagnostic/therapy changes and, consequently, increase costs”, noting that false positive alarms may also cause patients to become anxious.

“Not only is the sheer number of variables crucial, but also the type of variables collected. Malignant arrhythmic events might be epiphenomena of cardiac disease and its final common pathway. Therefore, in my opinion, the dynamics of the underlying cardiac disease can be better monitored by autonomic, haemodynamic, and ischaemia-related parameters. Using these signals might better allow for early detection of patient deterioration and avoidance of more severe complications,” Prof. Schmidt commented.

The session on electronic health records and computational technologies will discuss and review the opportunities with electronic health records into the investigation and prediction of arrhythmic risk (from genetics to pro-arrhythmic mechanisms). Looking at a topic of electronic health records from a more global perspective, Prof. Schmidt said that “so far” there has been “a plethora of rather small observational retrospective studies” and that most of these have shown positive results.

However, he added: “The number of larger observational studies is limited. The results from these studies have been less positive and validation studies in independent patient cohorts are needed but lacking at the moment.” Additionally, Prof. Schmidt noted, data protection issues have to be considered if information from such records is to be used in clinical science, “especially if collected on large scale and combined with biomaterial/genetic markers”.

The last session of the day, which was developed with the contribution of the ESC Working Group on E-Cardiology and the EHRA eHealth and Digital Rhythm Study Group, will look at wearables and the different technologies available. For Prof. Schmidt, the sheer number of wearable technologies (such as apps that measure heart rates) on the market is confusing.

He said: “At present, the companies behind these wearables are hesitant to provide information on details regarding data format and computation. But, as at the beginning of any new era in healthcare, one has to find standards. We have to have standard data formats that everybody can read and everybody can validate the results. In science, you have to be sure of what you are measuring.”

Overall, the purpose of the eHealth Summit is to review these issues and review the future possibilities that wearables and other eHealth technologies may provide.

Prof. Schmidt commented: “We have to think about the problems that we have to solve, but I am positive that most of them can be solved”. Therefore, he said, the key reasons for attending this summit are to “keep apace of this rapidly evolving field and to be aware of the current problems but to also see the potential for the future”. “This is a new path in patient care that is not going to stop,” Prof. Schmidt summarised.

eHealth Summit: Three sessions on Monday 19 June

View the programme