Grants

???With funding from the Beckwith Institute, we are using new technology as a health promotion tool to engage and motivate patients toward recovery and prevent complications that lead to hospital readmission.??? - Lisa Henry, DNP, CRNP, UPMC Heart and Vascular Institute-Center for Heart Valve Disease

TABLETS AND PERSONAL HEALTH MONITORING DEVICES FOR ELDERLY TAVR PATIENTS TO FACILITATE IMPROVED INTERDISCIPLINARY COMMUNICATION, PROMOTE PATIENT AND CAREGIVER ENGAGEMENT, AND PREVENT COMPLICATIONS

Grant Application

Lisa Henry, DNP, CRNP of the UPMC Heart and Vascular Institute’s Center for Heart Valve Disease in partnership with Donna Roth, Carol Remaley, RN, Jen Bevan, RN, Liz Christiansen, CRNP, Joon Lee, MD, Thomas Gleason, MD, Forozan Navid, MD,John Schindler, MD

 

Proposed Innovation

Patients who undergo transcatheter aortic valve replacement (TAVR) are elderly adults with congestive heart failure and other chronic chronic medical problems, including hearing and vision problems. This can lead to poor communication and quality of life, increased healthcare costs from readmissions, and patient safety concerns.

The goal of this project was to use technology to improve communication and education to ensure patients make informed, comprehensive decisions regarding treatment options. It also was designed to empower and motivate patients by providing tools they could use to track their real time progress in conjunction with decision makers and UPMC TAVR team.

 

Improvements in Action

Through this project, patients were shown educational videos on electronic tablets during consultation with the treatment team prior to the TAVR procedure. They also were offered a personal health monitoring device (Fitbit®) and scale (Fitbit Aria™) to track their activity, sleep, and weight for six months following the procedure. Data was stored on the UPMC website, where it could be viewed by patients, caregivers and providers. In addition, TAVR team members also monitored the data and contacted patients if they had any concerns, or to encourage and motivate them.

 

Results

The TAVR Team reported mixed results from the project. Use of the tablets generated positive feedback by patients and family members as well as the clinical staff. It proved to be a very useful teaching tool resulting in better informed consent after patients viewed the video. However, use of the Fitbit® and Fitbit Aria™ had little impact on hospital readmission rates, in part due to poor participation among the older patients, who found it overwhelming. In some cases, the technology was not compatible with pacemakers.

The TAVR team plans to update content on the tablet to include new valve options and other information. They also plan to include a desktop link and train more clinical staff on its use. Additional steps include extending use of the Fitbit technology to moderate risk patients who are younger with possibly more Internet access. Other considerations include offering the technology to other patients, including those undergoing aortic valve replacement surgery and non-TAVR patients with congestive heart failure.