John Pontarolo reviews recent patient transmissions and triages care based on the Patient List Evaluation Summary.

Northwest Florida Heart Group

Rapid increase in ICD implants means growing pains for follow-up clinic

Northwest Florida Heart Group (NWFHG) has specialized in the treatment of cardiovascular diseases for over 20 years. Today, the clinic's staff of six cardiologists and one electrophysiologist offer its fast-growing population of heart patients leading-edge services, including nuclear cardiology, echocardiography, interventional cardiology, and electrophysiology.

Over the past five years Clinic Coordinator John Pontarolo has seen the number of new ICD implants at NWFHG increase five-fold–from one or two new ICD implants a week to one or two a day. “This rapid increase,” says Pontarolo, “has meant some growing pains for our clinic, impacting our already jam-tight office schedule significantly. Each ICD patient typically has four follow-up visits a year. On “device-heavy” days, our schedule tends to back up because we typically spend more time with each follow-up patient, including programmer interrogation, reviewing medications, and doctor consults.” Further complicating the scheduling, Dr. Branco has just three days a week to see patients at the follow-up clinic.

“Having over 140 patients enrolled in the Medtronic CareLink Network has given me almost half a day a week to reinvest in my practice.” – Marcelo Branco, MD

Managing growth with the Internet-based Medtronic CareLink Network

To help ease patient loads and schedules, in October 2002 NWFHG implemented the Medtronic CareLink Network, an Internet-based remote monitoring service for Medtronic cardiac device patients. Integrating leading-edge device and information technologies, the Medtronic CareLink Network offers NWFHG’s follow-up clinic new opportunities for time-savings, enabling clinic staff to conduct a device evaluation remotely. “We can serve more of our patients more frequently and more efficiently,” observes Dr. Branco.

Since the remote monitoring service was implemented, more than 140 of NWFHG's Medtronic ICD patients have been prescribed the portable Monitor that allows them to transfer their device data to the Medtronic CareLink Network.

At the clinic's direction, patients transmit comprehensive, clinically relevant device data from home or while traveling* via a standard phone line using the portable Medtronic CareLink Monitor. Authorized clinic staff download the data from a secure server to any Internet-enabled computer for review on the password-protected clinician website. The data available on the Medtronic CareLink Network is comparable to that obtained during and in-office device interrogation and allows clinic staff to conduct a device evaluation in a fraction of the time it takes for an in-office visit.

“Medtronic CareLink Network features like the Patient List, the 10-second real-time EGM, and Episode Reports allow us to triage our patients and prioritize,” says Pontarolo. “We can see at a glance whose information we need to look at first.”

“The time freed up by remote device monitoring with the Medtronic CareLink Network is eagerly used by us to schedule new patients, procedures, and patients experiencing problems.” – John Pontarolo, Pacemaker Clinic Coordinator

Measurable benefits in time savings and convenience for both patients and clinics

Conducting three of four annual check-ups with the Medtronic CareLink Network for the 140 Medtronic device patients has resulted in at least one less patient appointment per day for Pontarolo and his staff: “The time freed up by the Medtronic CareLink Network is eagerly used by us to schedule new patients, procedures, and patients experiencing problems.” Dr. Branco also has observed a measurable benefit for his EP clinic: “Having over 140 patients enrolled in the Medtronic CareLink Network gives me almost half a day a week to reinvest in my practice. This has also had a positive impact on the EP lab because I am doing fewer late cases wth the call team after normal hours. And, most importantly, with this time-saving tool, our patients enjoy more comfort and convenience.”

“Patient response has been terrific,” according to Dr. Branco. Peace of mind and convenience are the two benefits mentioned most often by NWFHG’s Medtronic ICD patients who have been prescribed the Medtronic CareLink Monitor. The patients report that having access to care when and where they need it, and not having to come into the clinic for three of their four annual device check-ups, gives them greater freedom and added reassurance.

“The Medtronic CareLink Network has exceeded our expectations,” says Pontarolo. “With the continued rapid growth we can expect, the Medtronic CareLink Network will be an important tool for us to streamline schedules and grow at the desired rate, while providing quality care to our patients.”

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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