Remote monitoring and clinical outcomes: details on information flow and workflow in the IN-TIME study

Husser Daniela, Geller Christoph, Taborsky Miloš, Schomburg Rolf, Bode Frank, Nielsen Jens Cosedis, Stellbrink Christoph, M. D. Meincke, Søren Pihlkjær Hjortshøj, J Schrader, T Lewalter, G Hindricks

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

12 Citationer (Scopus)
117 Downloads (Pure)


Aims Randomized clinical trials investigating a possible outcome effect of remote monitoring in patients with implantable defibrillators have shown conflicting results. This study analyses the information flow and workflow details from the IN-TIME study and discusses whether differences of message content, information speed and completeness, and workflow may contribute to the heterogeneous results. Methods and results IN-TIME randomized 664 patients with an implantable cardioverter/defibrillator indication to daily remote monitoring vs. control. After 12 months, a composite clinical score and all-cause mortality were improved in the remote monitoring arm. Messages were received on 83.1% of out-of-hospital days. Daily transmissions were interrupted 2.3 times per patient-year for more than 3 days. During 1 year, absolute transmission success declined by 3.3%. Information on medical events was available after 1 day (3 days) in 83.1% (94.3%) of the cases. On all working days, a central monitoring unit informed investigators of protocol defined events. Investigators contacted patients with a median delay of 1 day and arranged follow-ups, the majority of which took place within 1 week of the event being available. Conclusion Only limited data on the information flow and workflow have been published from other studies which failed to improve outcome. However, a comparison of those data to IN-TIME suggest that the ability to see a patient early after clinical events may be inferior to the set-up in IN-TIME. These differences may be responsible for the heterogeneity found in clinical effectiveness of remote monitoring concepts.

TidsskriftEuropean heart journal. Quality of care & clinical outcomes
Udgave nummer2
Sider (fra-til)136–144
Antal sider9
StatusUdgivet - apr. 2019


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