An in-home cardiac rehabilitation program combining Samsung consumer devices, a custom patient-facing app and clinician dashboard integration achieved substantial lower rehospitalization rates among a cohort of 1,880 Kaiser Permanente patients than the national average, according to a writeup describing the program in NEJM Catalyst.

“This program took a fresh, digital-first approach to cardiac rehabilitation and put control in patients’ hands,” Peter Koo, corporate SVP and head of the Health Service Team and Mobile Communications Business at Samsung Electronics (which co-developed the program alongside Kaiser Permanente), said in a statement. “It produced higher program completion rates than programs requiring excessive trips to the doctor’s office.”

TOPLINE DATA

The system’s virtual cardiac rehabilitation program enrolled 2,362 patients from 12 medical centers in southern California as of June 2019, with 1,880 patients having completed the eight-week program. This 87% completion rate is nearly double that of traditional site-based programs, the Kaiser Permanente team wrote, with total referrals to any site cardiac rehabilitation increasing since 44.5% since the program’s launch.

There were 27 rehospitalizations within 30 days of the eight-week program’s completion, of which 17 were related to cardiac health. The researchers noted that this rate of readmission, roughly 1.4%, is a far cry from the 10% to 15% average reported nationally.

“The experience has exceeded our expectations,” they wrote. “With few exceptions, we have not had patients drop from the program as a result of technological challenges. A close partnership between Samsung support and our case managers has created a strong safety net.”

HOW IT WAS DONE

Kaiser Permanente and Samsung designed and developed a patient-facing smartphone app that links to Gear S3 and Galaxy Watch devices and helps patients maintain a daily checklist of exercises, tasks and medications. As patients use the system throughout the program, data from the wearable is transmitted to a compatible clinician dashboard, where the care team can remotely monitor their recovery and assign new exercise goals.

Patients who were eligible for the program were referred within Kaiser Permanente’s EHR. Patients attended an initial in-person appointment during which they were provided with the technology. From there, they were scheduled for weekly virtual meetings with their case managers and physicians.

Following a six-month, 37-patient pilot, the team scaled the program for the full regional deployment. Participants who graduated the program were also offered with several weeks of wellness coaching, if interested.

WHAT’S THE HISTORY

In-home rehabilitation has been highlighted as a viable approach to reducing costs and improving outcomes, and there’s little shortage of tools equipped for the job. Earlier this year, for instance, a paper published in Frontiers in Neurology described improved outcomes among stroke patients using an app developed by The Learning Corporation, while other data from Sword Health lent support to the Portuguese company’s digital physical therapy tool for total knee arthroplasty patients.