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Notifying Remote transmission results to patients

  • 1.  Notifying Remote transmission results to patients

    Posted 07-03-2024 15:15

    Hello HRS community.  I wanted to ask how you notify your CIED pts with remote transmission results.  We all now the challenges of volume burden and staffing.  Are you calling your patients with each transmission, mailing letters/postcards, sending a message on the portal is the patient is active, not notifying unless abnormal?  

    Historically every patient here has been called with results.  Staffing has changed and we are short staffed and running a backlog.  We have started sending portal messages to patients who are active (recently within the last 1-2 months).  However, we are still calling everyone else.  The staff is getting bogged down with questions that don't pertain to the transmission, which is having a significant impact on productivity.  How do you handle these challenges?  

    Thank you in advance!  Happy 4th of July.

    --Shannon



    ------------------------------
    Shannon Becker RN
    Lead Device Nurse
    Advent Health
    ------------------------------


  • 2.  RE: Notifying Remote transmission results to patients

    Posted 07-03-2024 15:34
    We tell patients that "No news is good news!" while they are being monitored remotely. If we see something of concern, "We will be contacting you!"
    We also tell patients with wireless transmitters that they will not have appointment times, that it is set up in the website to transmit automatically. We will be contacting them if we see their monitor has not been transmitting appropriately. Techs follow-up on monitors as needed.
    Those patients with manual transmitters do have appointments and our techs follow-up on missed appointments.
    For those few that want to know what their results are, we encourage them to sign up for our portal and ask for a report from time to time. The device reports do not automatically go to our portal at this time because we do not want patients get overly concerned about short arrhythmias of no clinical relevance.

    Best regards,
    Amy

    Amy S Leiserowitz, RN, CCDS, FHRS

    MercyOne Iowa Heart Center

    Heart Rhythm Education Specialist

    Pronouns: She/Her/Hers


    Desk: 515-633-3602 (Direct Line)

    Cell:   515-988-5234

    Fax:   515-288-1728

    amy.leiserowitz@mercyoneiowa.org


    Iowa Heart Center

    5880 University Ave

    West Des Moines, IA 50266


    MercyOne.org


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  • 3.  RE: Notifying Remote transmission results to patients

    Posted 07-04-2024 11:31

    Our OhioHealth System Device Department is not contacting pts to confirm remote transmissions have been received.  If pts are connected with our patient portal, MyChart, they do get an alert when the transmission has been resulted and in their chart.  We have over 12,000 active CIED patients.  We also do  not have the staffing to contact each patient when transmission received.  As we educate out patients we instruct them that no news is good news as well as if they are active with their patient portal they will receive an alert when transmission is processed.  We also address this in our patient education booklets that are given out at implant, gen change, or transfer to our clinic.

     

    Hope this helps.

     

    Thank you-

     

    Sharon Marsolf BSN, RN

    Clinical Manager, Device

    OhioHealth OPG Heart & Vascular

    Office:  614-788-2014

    Cell:  913-544-6395






  • 4.  RE: Notifying Remote transmission results to patients

    Posted 07-04-2024 17:18
    Edited by Mr. Gustavo Rodriguez Espinel, CET 07-05-2024 03:41

    Our cardiac monitoring center has implemented a very efficient system to manage the large volume of data. By creating a tiered system, you've ensured that each level of technician can focus on their specific area of expertise, which likely improves the accuracy and speed of your diagnoses.

    • Cardio Tech 1 handles normal EKGs, allowing them to quickly process and move on from these cases.
    • Cardio Tech  2 deals with critical reports, which likely require a higher level of expertise and more time to analyze.
    • The MD Tech then makes the call to the appropriate MD, ensuring that the most critical cases are escalated to the highest level of expertise available.

    This focus on arrhythmias and AV Blocks (AVB) ensures that abnormalities are not missed in the large volume of data. Additionally, by automatically sending regular transmissions to the patient chart, you're reducing manual work and the potential for error.



    ------------------------------
    Gustavo Rodriguez Espinel CET
    Monitor Technician
    Kp.org
    ------------------------------



  • 5.  RE: Notifying Remote transmission results to patients

    Posted 07-05-2024 09:29

    Hi Shannon,

       So for my practice, the messaging to patients regarding their remote checks is automatic.  We have it setup through our Epic integration wtih Murj that depending on the type of report (normal, normal with events, abnormal) there is a different, fully automated message that gets sent to our patients through a MyChart message.  If they do not have MyChart this same message is mailed to them, but those patients are told that if there is ever an issue someone will call them.  It has alleviated a lot of the strain on our staff, and patients actually like the messages as the messages also include a copy of their transmission and report.  

    Very Respectfully,

    James O'Hara PhD, DrPH, DMSc, PA-C 

    EP APP Lead

    Technical Director of Ambulatory Monitoring and Cardiovascular Implantable Electronic Devices (CIEDs).

    Cardiac Electrophysiology 



    ------------------------------
    James O'Hara PhD, PA
    EP APP Lead. Technical Director of CIEDs
    Virginia Heart
    ------------------------------



  • 6.  RE: Notifying Remote transmission results to patients

    Posted 07-06-2024 17:25
    James,

    Can you share more about this integration and how it automatically sends a letter please?  We are implementing Murj next Month and have not heard of this feature.

    Thank you,



    Original Message


  • 7.  RE: Notifying Remote transmission results to patients

    Posted 07-09-2024 10:26

    Hi Linda, 

        Sure thing.  I helped with the integration between Epic and Murj.  The Murj team side knows what to do, but you may have to ensure that it's part of your integration setup.  It basically works through the HLA7 document that Murj sends to Epic.  That document for us is a PDF that includes the Murj face sheet and the report from the company as a pdf file attached to the message/encounter as an image file.  Once the provider (MD for remotes, MD/APP for in office checks/hospital checks) signs off the report in Murj it is sent to Epic and on the Epic side it's directed into the Cardiac Procedures tab as either an "in office cardiac device monitoring" or a "remote cardiac device monitoring" encounter.  That encounter automatically triggers Epic to send a mychart message to the patient with a narrative and impression (that we pre-setup during the integration).  To keep things simple for Murj, Epic, and our EP team, we have that message set to trigger based off of how the docket in murj is labelled - either Normal no events, normal with events, or abnormal (green, yellow, red).  I'm happy to chat more in depth with you if you would like  (feel free to email me johara@virginiaheart.com).  

    Thanks and have a great day!!!

    James



    ------------------------------
    James O'Hara PhD, DrPH, DMSc, PA-C
    EP APP Lead
    Technical Director of Ambulatory Monitoring and Cardiovascular Implantable Electronic Devices (CIEDs).
    Cardiac Electrophysiology
    ------------------------------

    Original Message


  • 8.  RE: Notifying Remote transmission results to patients

    Posted 07-09-2024 10:41

    Hi Shannon –

     

    Presently, we notify patients of findings via their online Portal. The vast majority of our patients use the Portal, and this has been a huge satisfier not having to call each patient. If patients are not on the Portal, we will make a phone call – these are much fewer and far between than you may imagine.

     

    Please let me know if I can be of any further assistance.

     

    Regards,

     

    David Wasserman, MA, BSN

    Heart Rhythm Services

    Mayo Clinic Arizona

     

    CONFIDENTIALITY NOTICE – QUALITY ASSURANCE AND/OR PEER REVIEW DATA: This information is confidential and protected from disclosure by Arizona Revised Statutes (A.R.S.) §§ 36-445 - 445.04 and/or 36-2401 - 2404. This information may be released internally only to the extent necessary to carry out the purposes of peer review or quality improvement of patient care.

     




    Original Message


  • 9.  RE: Notifying Remote transmission results to patients

    Posted 07-09-2024 07:52

    Our process is much the same as Amy's. No news is good news.  We educate our patients with the understanding that our clinic will contact them if it is necessary to do so. However, with the Cures Act we must release results to patients if they have a portal.

     

    Best regards,

     

    Michael Silva, RN, RCES, CCDS
    Supervisor, Arrhythmia Device Clinic

    WellSpan Heart & Vascular Center
    msilva@wellspan.org

     

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