Cardihab will help researchers understand the risk of COVID-19 infection and isolation for people with reduced heart function as part of a project to be undertaken at an innovative new COVID-19 rapid response research centre.
The Wesley Medical Research virtual COVID-19 Rapid Response Research Centre aims to support the global community to fast-track answers to overcome COVID-19. The centre had its official opening last week.
Cardihab’s digital health platform will be used in one of the first research studies conducted by the Centre. This piece of research, led by Dr John Rivers, will examine the impact of COVID-19 infection and isolation on patients with reduced heart function.
At-risk cardiovascular patients are among the many vulnerable people who are isolating to reduce the risk of COVID-19 infection. These same people are inadvertently potentially exposing themselves to a new set of risks by the very process of isolation; reduced medical care, missing routine medical appointments, inactivity and weight gain as well as poor control of hypertension and other comorbidities.
Dr Rivers explained that while the COVID-19 risk is high, chronic heart conditions remain the major cause of death in Australia and globally. Looking after these patients therefore should remain a priority and this project hopes to improve their care during the pandemic.
“We need to balance the requirements of protecting those people from the virus with the risks of protection itself,” Dr Rivers said.
The study aims to assess whether a digitally-enabled management strategy provides improved outcomes when compared with conventional care in a cohort of Left Ventricular Dysfunction (LVD) patients who are infected with, or isolating to avoid, COVID-19 infection. It is likely those with LVD or heart failure who become infected with COVID-19 will see a deterioration of left ventricular function.
This study will use Cardihab’s clinically validated digital model of care to enable physicians to care for patients with impaired heart function remotely. Using the Cardihab app via smart phone devices and the secure clinician portal, physicians will be able to assess whether this model of care improves outcomes for those at-risk patients in terms of heart failure readmissions, deterioration of symptoms and their condition. Quality of life and mental health status will also be assessed in this study.
The transition from conventional care to models incorporating digital healthcare delivery has been accelerated as a result of COVID-19 and this change is likely to be sustained in the way chronic diseases are managed in the future.
“The impact of isolation and COVID-19 has given us the chance to reconsider how we deliver healthcare in the future, to a model which is more patient centred, user friendly for the consumer, and enables better outcomes,” Dr Rivers said.
The use of evidence-based digital health technologies is set to become the new standard in chronic disease management. Helen Souris, Cardihab CEO welcomes the technology transformation currently taking place in the healthcare sector and is an advocate for establishing evidence-based digital health technologies as a standard of care.
“We are proud to collaborate with Wesley Medical Research and Dr Rivers to enable a better understanding the benefits of technology in managing patients with chronic heart conditions affected by COVID-19 and isolation,” Ms Souris said.
One of the outcomes from the COVID pandemic is the fast-tracked adoption of technology to care for and triage patients through the healthcare system. But still, questions remain about the role of age in identifying patients who can benefit from these new ways of delivering patient care.
Telehealth and digital health platform usage surged as traditional models of care were either restricted or abruptly ceased to minimise the risk of exposure to COVID-19. Cardiac rehabilitation services across Australia were among those that were significantly disrupted, resulting in many clinics seeking to introduce remote models of care, frequently including digital solutions such as the Cardihab platform.
Cardiac rehabilitation is recommended for any patient who has an acute cardiac event, generally the result of cardiovascular disease (CVD). While not exclusively a condition for people over the age of 45, the vast majority of Australians with CVD fall into the age groups of 65-74 (30% of CVD patients) and 75+ (32.5%). Therefore, chronic CVD and cardiac rehabilitation patients might not be the first clinical population thought of as suitable users of digital health apps.
However, recent data from 200 patients enrolled in Cardihab's digital cardiac rehabilitation program suggests that age might not be as clear cut a factor when deciding who to prescribe digital health programs. Data from our real-world experience has shown that 59% of our patient users are aged over 60, with those aged between 70 and 80 representing the largest patient group (31% of users).
In the Cardihab context, a patient is referred and enrolled in a digital cardiac rehabilitation program by a Healthcare professional (HCP). Their prescribed program is delivered via the Cardihab app and supervised throughout the course of their program by a qualified HCP. While it is feasible that user age in our sample is influenced by the demographics of the HCP’s patient population, this is an important insight into the potential user age differences that might be observed between a prescribed and clinically guided digital health app like Cardihab vs a freely available consumer self-help app.
What is becoming clearer as the collective evidence grows, is that technology access and literacy are important pre-requisites for using digital health platforms. In particular, technology literacy is an important factor for determining which patients would be suitable for digital health apps. From our experience, these 3 simple questions provide adequate insight into a person's tech literacy to enable a decision as to whether to prescribe digital health app to a patient or not.
- Do they have a smart phone? Yes/No
- Do they currently use apps for general living? Yes/No
- If so how often?
Patients that use apps at least weekly are likely to have the aptitude to use digital health apps efficiently and effectively. We therefore encourage HCPs to consider asking these simple tech literacy questions before ruling someone out of a digital health app.
While there is still much to learn about the use of digital health apps in the management of chronic cardiovascular disease, we are encouraged by our observations on the age of patients enrolled in our digital program. We look forward to contributing further insight as our real-world experience grows and as digital health apps take their place as an important option for chronic disease management.