"Remote monitoring with the CareLink Network cuts down the congestion in our office, freeing up our office schedule for new procedures and acute problems that need to be worked in." Regina Owen, RN

Stern Cardiovascular Center

The Stern Cardiovascular Center, Memphis, Tennessee

Medtronic CareLink® Network helps The Stern Cardiovascular Center provide timely and convenient care to a rapidly growing number of cardiac device patients

"Our experience with the CareLink Network has been excellent. It has helped us enhance patient care, increase capacity, and gain a competitive edge. The Network allows us to continue to grow."
Eric Johnson, MD

Over the last three years, The Stern Cardiovascular Center has seen explosive growth in the number of ICD follow-up checks per year. The total of 375 ICD patient checks performed by its Pacer/Arrhythmia clinic in the year 2000 is projected to exceed 1,645 by the end of 2003 — a more than 430% increase over a period of three years. Pacemaker follow-up visits have grown by 32% during the same period.

The Memphis, Tennessee heart clinic was founded in 1920 by Neuton S. Stern, MD (1890 — 1969), father of Thomas N. Stern, MD, who continues to practice cardiology today as one of the Center's fifteen heart specialists. Serving a four-state area that includes Arkansas, Missouri, Mississippi and Tennessee, the Center has a large research department that is regularly involved in multiple studies.

The Pacer/Arrhythmia clinic's two electrophysiologists, Eric Johnson, MD and Mark Coppess, MD, four nurses, one certified cardiac technologist, and two technical assistants follow approximately 3,000 cardiac device patients – 70% pacemaker and 30% ICD patients.

"With increasing indications for device implants, we have seen a marked increase in ICD patient volumes at our clinic," says Eric Johnson, MD. "We needed to put a strategy in place that would help us manage that growth."

As part of their growth strategy, The Stern Cardiovascular Center decided to implement the Medtronic CareLink Network, the first and only Internet-based remote monitoring service for cardiac device patients. At the clinic's directive, the prescription device allows Stern's Medtronic ICD patients to transmit comprehensive ICD data from home or while away using a standard phone line. Authorized clinic staff then download the data via the Internet to review episodic events, device parameters, and a 10-second EGM online.

Since implementing the Network in October 2002, Stern Cardiovascular has prescribed the Medtronic CareLink Monitor for nearly 100 of their Medtronic ICD patients. Two of their four regularly scheduled follow-up appointments have been replaced with Medtronic CareLink remote monitoring sessions. With each patient on average now requiring one less hour of collective clinic staff time per in-office follow-up visit, the clinic estimates this alone has saved 200 hours a year, equivalent to 200 annual follow-up visits.

"Remote monitoring with the CareLink Network cuts down the congestion in our office, freeing up our office schedule for new procedures and acute problems that need to be worked on."
Regina Owen, RN

Pacer/Arrhythmia Department Supervisor Regina Owen, RN summarizes the benefits of remote monitoring with the Medtronic CareLink Network for both her clinic and its patients: "As more devices are being implanted and our clinic's patient load increases, remote monitoring with the CareLink Network cuts down on the congestion in our office, freeing up our office schedule for new procedures and acute problems that need to be worked on. For our patients, using the CareLink Network means a welcome reduction in both travel time and waiting, especially for our ICD patients in outlying rural areas." Owen and her staff have found the Patient List feature of the Medtronic CareLink Network especially useful, as it displays significant events such as shocks, episodes, battery and lead issues, Patient Alerts in bold, and shows whether a shock or episode has occurred since last transmission. These features allow them to prioritize care and address urgent situations immediately. Since patients are able to transmit data at the clinic's direction for immediate analysis if they experience episodes or shocks, Regina Owen believes that patient care has been improved in terms of both convenience and peace of mind.

After using the Medtronic CareLink Network for almost a year, Stern's EP staff is confident about its performance and benefits to their clinic operations, as well as the positive impact on their patients' lives. As use of the Internet-based remote monitoring service increases, Dr. Johnson and Dr. Coppess say they may consider shifting the majority of routine device checks for stable ICD patients to the Network, bringing many patients into the office only once per year. Both EPs commented how time that traditionally would have been spent for routine appointments has been freed up to see new patients and perform procedures. They also say it has enabled them to conduct office consults in a more timely manner. With an average of 10—15 additional ICD implants per week now being performed by the two EPs, remote monitoring with the Medtronic CareLink Network will continue to play an important role in helping Stern's Pacer/Arrhythmia clinic save appointment time, improve patient care, and streamline scheduling.

"The Medtronic CareLink Network reassures our patients that we are doing everything possible to keep in touch with them, even when they're at home."
Regina Owen, RN

According to the clinic, patients have especially appreciated the ease-of-use and convenience of the portable Medtronic CareLink Monitor. Recently, a patient who was temporarily homebound as the result of a hiking accident transmitted device data at the clinic's direction after experiencing episodes. The transmitted data documented episodes of AF — a new diagnosis revealed for the first time by the Medtronic CareLink interrogation. Because of the monitor, the patient was able to be treated without an office visit. And, for some of the patients who live great distances from The Stern Cardiovascular Center, data captured with the Medtronic CareLink Network can be transmitted to satellite hospitals, allowing them to receive treatment locally.

"Patient acceptance has been a key aspect of the success we have had with the Medtronic CareLink Network," says Dr. Johnson. "The Medtronic CareLink Network has helped us enhance patient care, increase capacity, and gain a competitive edge. The Medtronic CareLink Network allows us to continue to grow."

This case study recounts one clinic's experience using the Medtronic CareLink Network for remote device follow-up. Medtronic, Inc. cordially invited doctors and clinic staff to share their story. Please bear in mind that this experience is specific to this clinic. Results may vary. Not every clinic will have the same results.

The Medtronic CareLink® Network is a prescription device indicated for use in the transfer of patient data from some Medtronic implantable cardiac devices based on physician instructions and as described in the product manual. This product is not a substitute for appropriate medical attention in the event of an emergency and should only be used as directed by a physician.

*The Medtronic CareLink Network is currently available for use in the continental U.S., Alaska, and Hawaii.

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