Heart failure is a major public health problem. For terminal heart failure the treatment of choice used to be heart transplantation during the last three decades. But this is changing, largely due to a decreasing supply of donor organs: “The alternative therapy nowadays is the implantation of a left ventricular assist device (LVAD),” states Prof Dr Nils Reiss, Head of Clinical Research at Schüchtermann-Klinik in Germany. “With the exponential increase in the use of LVADs, caregivers now face a higher frequency of readmissions because of serious complications occurring out of hospital such as thrombosis of the LVAD pump, right heart failure, arrhythmia, driveline infection or bleeding – all of which are associated with high costs for the healthcare system,” Reiss says.
'Telemonitoring can prevent complications, readmission and cost-intensive treatment'
Readmissions and late interventions in LVAD patients are expensive. A severe pump thrombosis, for example, can make it necessary to replace the LVAD completely, ranging from €70,000-80,000 for the device only. “Detecting pump thrombosis early by means of telemonitoring can prevent such a scenario,” heart surgeon Reiss points out. Reiss is the German project co-ordinator for ‘Medolution’, an international telemonitoring project aiming to apply long-term monitoring and real-time decision support for the diagnosis, treatment and further monitoring of LVAD patients in reactive and preventive cases. The project is not only about costs. “Detecting LVAD-related complications early by means of telemonitoring can also improve patients’ quality of life significantly,” Reiss continues, as he outlines the vision and potential of the project.
To make this happen, a multidisciplinary consortium was installed consisting of 19 partnering companies and institutes across five countries including the Netherlands, France, Germany, Turkey and Canada. Their expertise ranges from medical big data management, security, interoperability and up to system integration. Supported by ITEA, the EUREKA Cluster programme supporting innovative, industry-driven, pre-competitive R&D projects in the area of Software-intensive Systems & Services (SiSS) ‘Medolution’ is run with an overall budget of €22.7m and terminates in May 2019.
As for the German consortium with its six partners, the main focus is on the development of the telemonitoring system. German sub-project leader Schüchtermann-Klinik in Bad Rothenfelde addresses the long-term secondary prevention of LVAD patients. The long-term aim is to establish a telemedical service centre for LVAD patients. Until now, patients after LVAD implantation had to come for routine check-ups every three months.