Imagine if improving your health was as simple as downloading an app. While it’s not quite that easy, a team at Atrium Health’s Sanger Heart & Vascular Institute has spearheaded a new approach to post-operative care for cardiac patients – and it does involve some cool tech gadgets. The Perfect Care initiative, announced in July 2018, seeks to improve health in patients who have recently had cardiac surgery and live in rural areas of North Carolina.
A new approach to an old problem
The Perfect Care team at Atrium Health's Sanger Heart & Vascular Institute, is led by Kevin Lobdell, MD, chairman & executive director; Kerstin Liebner, RN, director; and Shannon Crotwell, RN, BSN, clinical nurse navigator. Together, this group - along with a larger team - is taking a novel approach to an ongoing question for many healthcare prescribers. How do you make sure patients - in this case, patients who recently had heart surgery - receive the best possible follow-up care? It's an especially pressing concern in cases where the patients, many of whom live in rural areas, can't easily come into a doctor's office for face-to-face visits. Perfect Care offers a solution to this issue by allowing these patients to receive the care they need, without having to leave their home.
How the program works
Perfect Care enlists the latest technology - like smartphones or tablets, wearable devices, and digital scales - to help keep an eye on patients' health and well-being. The Perfect Care team monitors patients' vital stats and provides interactive, virtual visits with the clinical team via video chats.
Perfect Care includes education; remote monitoring of heart rate, blood pressure, steps, sleep, and weight; and virtual visits with the clinical team. In order to improve care, patients are also asked for feedback about their emotional, social, and physical health and recovery. All of this is provided at no cost to the patients, thanks to a grant award from The Duke Endowment.
Making strides in providing better care
So far, Perfect Care has enrolled nearly 70 cardiac patients. Each patient is provided with a digital toolkit, which includes a blood pressure monitor, a scale, and a wearable device that measures activity and heart rate. Each patient’s weekly virtual visit with the Perfect Care team is held via video chat.
“The program started at Atrium Health Pineville and has now expanded to Atrium Health’s Carolinas Medical Center (CMC), and it will eventually be expanded to three Atrium Health hospitals,” says Crotwell. “Right now, we have three full-time navigators.” She says response to Perfect Care has been very positive so far, with patients as young as 32 years old to as old as 86 years old participating.
“We set patients up with a digital toolkit, and then we monitor key health indicators such as weight, blood pressure, and heart rate remotely,” Shannon explains. “We also offer virtual visits on a weekly basis for up to 90 days after the patient has been discharged following cardiac surgery.” The virtual visits typically last 15 to30 minutes. The team can also help close other gaps in care – in one instance, the Perfect Care team was able to connect with a physician who offered in-home care to get lab work done for a patient who was unable to leave the house.
Patients who experience the Perfect Care difference
Erika Johnson went to the emergency department when she was experiencing shortness of breath and dizzy spells that were so bad she blacked out and was unable to work. Erika was diagnosed with hypertropic cardiomyopathy, a thickening of the heart muscle which makes it difficult for the heart to pump blood, as well as mitral valve insufficiency. The Sanger team implanted a pacemaker and performed valve replacement surgery. After her procedures, Erika was able to receive follow-up care through Perfect Care.
“I had doctors that didn’t give up on me and truly listened to me. That’s something that I appreciate so much because they changed my life,” says Erika. “People like Shannon keep in touch with me, and all the doctors and staff provide consistent care.”
Erika has been making progress slowly but surely.
“Now I can walk up to 45 minutes and not be exhausted,” she says. “Before my surgery, I was only able to walk for 2 minutes before I was completely out of breath.”
Erika, who lives in Concord, North Carolina, also says she appreciates the convenience of not having to travel to receive her follow-up care. She’s continuing to make changes to support her health and recovery. “It’s a matter of changing your lifestyle, and I have experienced a lot of positive results in just under a year,” she says.
Looking to the future
Perfect Care is going beyond remotely monitoring the patients – it’s also collecting self-reported information from the participants and tying it to the results they see after taking part in the program.
“We’re the only cardiac program in the area that’s integrating all these elements,” says Dr. Lobdell. “We collect quantifiable information that allows us to learn more quickly than we ever could before. We can use that information to really improve how we care for patients -- both now and in the future.”
Heart Care at Sanger Heart & Vascular Institute
