Reducing the Impact of Congestive Heart Failure through Remote Monitoring of Patient Weight Data

One morning, an 82-year-old woman gets on her scale – as she does every morning. Her weight seems a bit high to her; she is slightly worried, but quickly forgets about it. Half an hour later the phone rings. It is the nurse from the clinic. The patient, who is equipped with a wireless scale, has automatically transmitted the reading to the clinic. As she has a history of congestive heart failure (CHF), the nurse is concerned about her 3 lb jump in weight from the previous day, because this could be the sign of a possible fluid build-up in the lungs and thus increasing pressure on an already stressed heart. An immediate visit to the clinic is arranged and treatment begins until the patient is out of danger. Had the warning sign not been noticed and the problem not addressed so quickly, this could easily have resulted in a long, painful, and expensive hospitalization.

Growing Problem

There are approximately 5.3 million people with CHF in the US. The lifetime risk of developing heart failure at the age of 40 is 20 %, and approximately 380,000 people above the age of 65 are diagnosed with the condition every year. The incidence of heart failure has remained stable over the past 20 years; however, its increased incidence in the over-65-year-olds (attributed to the aging baby boomer generation) coupled with longer survival rates will give rise to a far greater number of patients with heart failure in the coming years.¹

A great cause for concern has been the increasing number of patients being hospitalized with CHF. The number of patients with CHF discharged from hospital in the US rose from 400,000 in 1979 to over 1 million in 2005.¹ Furthermore, 47 % of patients are likely to be readmitted within four to six months of having been discharged.² In 2004, CHF was listed as the underlying cause in 57,120 deaths, and the figure rose to 284,365 when the total mention of diseases was included.¹ From 1996 to 2000, the five-year mortality rate for patients with CHF was 48 %.³

The total direct and indirect cost of heart failure in the US is estimated to be $34.8 billion for 2008, with the greatest cost being hospitalizations.¹ In the commercially insured, Medicare and Medicaid populations, the single largest health expenditure is inpatient utilization of hospital services (nearly 33 % in 2005), and 13.3 % of all emergency department visits are associated with a hospital admission. The average cost associated with a CHF hospitalization is $10,000. While approximately 14 % of Medicare beneficiaries have heart failure, they account for 43 % of Medicare spending.⁴