Above photo: Patient Judy Chorney using the TEC4Home technology to collect her biometric data.
When Vancouver resident Judy Chorney began experiencing shortness of breath, shoulder pain, and bloating, she never thought the problem had to do with her heart. Yet in January 2017 she was admitted to the hospital and diagnosed with congestive heart failure, a life-threatening condition.
“It was scary: doctors told me I would need a triple bypass and mitral valve repair, which is a major operation," says Judy, now 63. “They set my surgery a few months down the road, and then they sent me home."
But Judy didn't go home alone – doctors at Vancouver General Hospital equipped her with TEC4Home, an innovative technology that aims to improve the patient care experience and reduce unnecessary emergency room visits. Early results have been so successful that the project has now expanded to phase 2 clinical trials, recruiting patients across British Columbia.
The statistics for Canadian heart failure patients are staggering: one in four patients will be readmitted to the hospital within one month of discharge, and 40 per cent will be re-admitted within four months.
In fact, British Columbia has the second highest hospital re-admission rate across all Canadian provinces, says TEC4Home Principle Investigator Dr. Kendall Ho, something he and his team hope to change with their innovative study.
“It's tough for heart failure patients to go home when they get discharged from the hospital," Dr. Ho explains. “TEC4Home uses home monitoring technology and nurses to monitor patients after they leave. We want to intervene early so the patient doesn't need to get worse and worse and finally end up back in ER."
How the technology works is simple: TEC4Home partner Telus Health equips patients with a weigh scale, a blood pressure cuff, a finger clip to measure heart rate and blood oxygen levels, and a tablet to answer questions about symptoms. Patients collect their biometric data daily for two months after leaving the hospital, and the information is accessed remotely by TEC4Home nurses.
All patients receive daily check-in calls from their designated nurse. If something is flagged as abnormal – for example, a patient's blood pressure is higher than usual – the call is prioritized.
TEC4Home equipment is provided by Telus Health
Phase one of the study involved 70 consecutive patients experiencing heart failure at VGH, St. Paul's Hospital, and Kelowna General Hospital. The results were encouraging: there was a 59 per cent reduction for heart failure re-admission, a 44 per cent drop in ER re-visits, a 44 per cent reduction in cost per patient, and 100 per cent improvement in patient self-reported quality of life.
Dr. Ho is cautiously optimistic about the initial results. His team has now moved to a significantly larger phase two trial (launched early August) in partnership with VCH, Providence, Interior, and Fraser Health to validate their results. Twenty hospital sites across the province are involved, including in Vancouver, Surrey, Lillooet and Sechelt, and 900 patients are being recruited.
Trials have also been implemented for Chronic Obstructive Pulmonary Disease (COPD), a chronic and progressive lung disease.
“As digital health and technology evolves, we want to create a system that's not only good for healthcare but also good for patients and their caregivers," says Dr. Ho. “It can be a scary thing when patients feel their health is out of their control, and this helps people feel physically and psychologically safer when they go home."
Patient Judy Chorney says her experience using TEC4Home was nothing but positive.
“The system is excellent, it was a positive experience for me – and the nurse was really, really good," she said. “You felt like somebody cared, you got good information, and any fears you had were decreased because it was spelled out for you logically, and you knew that somebody would note any changes right away."
Her only complaint? Judy wishes she could have used TEC4Home for longer.
“I think the program should be mandatory in hospitals for people like me," Judy adds. “You really learn about your body, and about your situation – I don't know how people without this support get through it."
TEC4Home is a partnership between Vancouver Coastal Health, Interior Health, Fraser Health, UBC Faculty of Medicine, the Canadian Institutes of Health Research, the Michael Smith Foundation for Health Research, the BC Ministry of Health, Telus Health, Providence Health, Cardiac Services BC, Vancouver Division of Family Practice, Vancouver Coastal Health Research Institute and VGH & UBC Hospital Foundation. It is supported by the Pacific Health Innovation eXchange (PHIX), which aims to accelerate research to improve patient care.