Key result
Multidisciplinary teams using algorithmic titration and remote monitoring may improve HF care and predict decompensation.
Why the study?
Efforts to rapidly and safely improve adoption of guideline-directed medical therapy for heart failure at the population level are limited and need prioritization.
The combination of technology, multidisciplinary teams, and EHR-based population identification is central to improving guideline-directed medical therapy adoption in heart failure.
Remains hypothesis-generating for tech-enabled multidisciplinary HF care; prospective trials needed before practice change.
PURPOSE OF REVIEW: Given the limited population level, adoption of optimal therapy that has been shown in recent clinical trials and heart failure registries, efforts to rapidly and safely improve adoption of guideline-directed medical therapy for heart failure should be prioritized. Opportunities to leverage remote monitoring technology, the electronic health record (EHR), and multidisciplinary teams to improve heart failure care merit review. RECENT FINDINGS: Dedicated multidisciplinary teams employing algorithmic medication titration schema have shown better efficacy than clinician alerts or quality initiatives that focus on education and audit-feedback processes alone. Technology that enables invasive pressure monitoring and wearable devices that transmit physiologic data have the potential to predict decompensation and allow for early intervention by alerting clinicians to signs of congestion/clinical worsening but further real-world data is needed to prove efficacy and develop effective treatment protocols. SUMMARY: The combination of technology, multidisciplinary teams, and identification of populations for intervention using the EHR will be central to impactful innovation in heart failure population health and prevention of avoidable morbidity. Novel approaches to study implementation efforts including cluster randomized trials are needed.
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Martyn et al. (2022) conducted a review in Heart failure. Multidisciplinary teams, EHR tools, and technology was evaluated. Multidisciplinary teams employing algorithmic medication titration and remote monitoring technology show potential to improve heart failure care and predict decompensation.
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