Right Heart Care In the Right Place

2023

Atrial fibrillation and heart failure are two of the major cardiovascular challenges of our time. It is important that these conditions are detected in time and treated according to guidelines. This is far from always the case. It is sometimes not clear that certain symptoms are caused by atrial fibrillation or heart failure, neither to the patient himself nor to health care providers. As a result, it sometimes takes a long time before someone receives the right treatment.
The chronic nature of heart diseases such as atrial fibrillation and heart failure also means that patients with these conditions are seen by many healthcare providers. To achieve this in a high-quality and transparent manner, optimal cooperation between the various care domains is necessary. It is important that the principle of right care in the right place (JZOJP) is applied. However, network care is complex and the effective organization of JZOJP by the right healthcare professional is still far from commonplace despite the many initiatives.

The origin
Better treatment of these conditions was a priority on the cardiovascular disease research agenda. This is why the Dutch Heart Foundation and ZonMw have started the thematic collaboration “Right Heart Care In the Right Place". By combining expertise, we want to detect as many people as possible with atrial fibrillation and heart failure early and treat them optimally. We are doing this in various ways: jointly setting up subsidy rounds to support regional collaborations, supporting a national support structure for the regions and overarching activities that contribute to knowledge development.

As part of Right Heart Care In the Right Place, the network program of the Dutch Society of Cardiology, NVVC Connect, together with involved network partners, facilitates an adequate national support structure for affiliated regional collaborations, or Connect regions. The Connect regions are supported and guided in, for example, preparing the subsidy application and they receive support during the implementation of the regional transmural agreements.

The research
The Right Heart Care In the Right Place consists of two forms of support:

the National Impulse: the aim is to set up a sustainable national support structure that stimulates and guides regions in the regional design and implementation of network care in the field of atrial fibrillation and heart failure
the Regional Impulse: the aim of the Regio-Impulse Cardiac Care is to support regional alliances, the Connect regions, in implementing regional transmural agreements. By bringing together the various care providers from the 3rd, 2nd and 1st line, these collaborative ventures jointly offer cardiological care for atrial fibrillation or heart failure more integrally and transmurally. In this way, the patient comes into contact with the healthcare provider who can best contribute to the care need at that moment. A maximum of 22 Connect regions can receive funding to implement the transmural agreements or to optimize the implementation in their region.

Collaborators

Funded

Contact person:

Anja de Bruin

adebruin@nvvc.nl

Principal investigators

Dr. Jan van Ramshorst

Voorzitter NVVC Connect

Anja de Bruin

Programmaleider Impuls Hartzorg

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Heart failure poses a large burden on patients and healthcare, largely because heart failure patients have low fitness and require frequent hospitalisation for close monitoring. In CardiacCare@Home, researchers work together with patients, doctors, industry, and others to develop technology for home-based monitoring of cardiac function and rehabilitation. This approach facilitates early detection of worsening of cardiac function, which allows doctors to rapidly alter treatment and prevent hospitalisation. Moreover, home-based rehabilitation will improve patients’ fitness levels. Technological innovations will facilitate a new care path that improves patients’ quality of life and lower socio-economic costs, and lower burden for hospital staff.
The research
CardiacCare@Home has the following aims:

To integrate a feasible, easy-to-use monitoring + biomarker system within the home environment of patients with HF, that is validated against gold standard measures, and to identify parameters suitable for integrated, frequent patient evaluation to improve and personalise treatment.
To design an inclusive transmural home-based cardiac rehabilitation programme, personalised to patient (and caregivers) and disease characteristics, tailored to the needs and preferences and co-created with relevant end-users using a combination of user-friendly sensors and an eHealth platform.
To develop a data analytics and decision support system to be incorporated in a novel eHealth platform to (i) enable effective monitoring of vital signs for the personalised, early detection of clinical deterioration, and (ii) facilitate personalised behaviour change to improve participation in rehabilitation.
Co-develop an integrated, AI-driven, home-based monitoring and/or home-based rehabilitation program in patients with chronic HF after hospital admission due to decompensated HF, and assess its effects on quality of life, functional capacity and re-hospitalisation (WP3).
To assess the impact, including cost-effectiveness and budget impact, of the home-based monitoring and/or rehabilitation CardiacCare@Home-intervention compared to current care from the perspective of patients with HF, healthcare providers, health insurance companies, and society.

The origin
Heart failure is linked to poor hospital recovery, low functional capacity, and high risk of hospital re-admission. CardiacCare@Home aims to develop and adopt innovative technology for home-based monitoring and cardiac telerehabilitation to improve quality of life, reduce admission and lower healthcare costs.
This project was funded by the NWO perspective TTW. This public-private program stimulates the development of innovative technologies that may impact economy and society.

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STRAP

2020

The STRAP consortium aims to reduce the burden of heart disease by early detecting heart disease deterioration, benefiting patients, healthcare workers, and society. This initiative responds to acute needs observed in cardiology clinics, combined with the increasing availability of health tracking technologies. The project focuses on developing a new, AI-powered solution using cost-effective technology to maximize impact on healthcare costs.
The Research
STRAP is dedicated to developing a comprehensive data collection platform integrating off-the-shelf and cutting-edge self-tracking technologies. This platform empowers patients to measure vital signs at home, eliminating the need for frequent clinic visits and enabling longitudinal data collection on daily activities and emotions. The platform enhances self-tracking adherence through gamification strategies. The project involves developing and evaluating novel diagnostic and prognostic methods through two trials with target groups where notable improvements are achievable and highly impactful:

Trial for Elderly Heart Patients: reducing re-hospitalization among elderly heart patients to minimize health deterioration and healthcare costs.
Trial at Cardiac Outpatient Clinics: lower costs and enhance the quality of heart disease diagnosis for individuals attending cardiac outpatient clinics.

The foundation of the trials is twofold. Establishing a Robust Dataset: creating an interconnected dataset to evaluate digitalized techniques' performance in relation to health records. This dataset incorporates electrocardiography data, stethoscope audio recordings, wrist-worn device activity levels, electronic nose sensor data, and self-reported information via IoT technologies, including parameters like water consumption, sleep patterns, real-time feelings, physiological responses, and overall patient well-being. Employing this diverse dataset, STRAP develops innovative analysis and early diagnosis methods to advance heart disease detection and monitoring.
Through these efforts, STRAP aims to implement advanced technologies and data-driven approaches to significantly impact heart disease management.
Origin
This project was funded within the Big Data & Health Program. The focus of this public-private research program is the use of big data for the early detection and prevention of cardiovascular diseases. The program has been developed by NWO, ZonMw, the Dutch Heart Foundation, the Top Sectors Life Sciences & Health (LSH), ICT and Creative Industry, the Ministry of Health, Welfare and Sport, and the Netherlands eScience Center. Within this research program, the ambitions of the Dutch Heart Foundation, the Ministry of Health, Welfare and Sport, and the Netherlands eScience Center were aligned with the ambitions of Commit2Data for the Top Sectors ICT, LSH, and Creative Industry, as described in the 2018-2019 Kennis- en Innovatiecontracts between NWO and the Top Sectors.

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