Karolinska moves in to the homes of patients with heart failure


Karolinska is leading a new, regionwide project that follows patients after they’ve been discharged. Patients, including those with heart failure, report data concerning their health status from their home. This allows any deterioration to be discovered more quickly, thereby reducing the risk of a relapse.

Karolinska University Hospital, together with Södersjukhuset, Danderyd Hospital, Södertälje Hospital, Stockholm County's Healthcare Area (SLSO) and the Regional Leadership Office have been awarded a grant of SEK 10 million from Vinnova in order to develop the approach, technology and methods for remote monitoring. This involves patients who have experienced serious illness and who need contact with specialised and highly specialised care even after they have the left the hospital.

"We will develop our working approach, investigate the patient's capacity to actively contribute to their own care, and test different technological solutions. Our ambition is to reach a procured innovation partnership with several different suppliers in order to meet the needs of both patients and care-providers for various conditions", explains Kristina Groth, who works as an innovation manager at Karolinska.

One of the pilot projects concerns patients with heart failure. In addition to a mobile telephone, the patient requires a blood pressure monitor and a set of scales. Measurements of blood pressure, heart rhythm and body weight, and a self-assessment according to a scale of symptoms, are reported to the care-provider on a daily basis.

Factor for success

"The crucial factor for success is not actually the technology, which has been well-developed, but the clinical competence required to ensure that all the information from the monitoring is used correctly", says Professor Frieder Braunschweig, who is Director of Cardiology at Karolinska.

"This is why we want to establish a telemedical centre at Karolinska. There, a nurse with clinical experience will be able to read and interpret all the information, and, following consultation with doctors, any actions required can be implemented."
The development of algorithms will assist with the interpretation in long-term data analysis.

Heart-failure patients who seek emergency care have often experienced gradual deterioration. It is the first three months after a patient has been admitted with heart failure that are the most critical with a high risk of a relapse.

Possibilties with remote monitoring

"Remote monitoring makes it possible for the care to be individualised. Serious courses of illness can now be discovered at an earlier stage, which enables us to prevent the patient's condition from deteriorating. At the same time, we do not need to call the patient in for tests if we can see that their condition is stable and they feel fine", says Frieder Braunschweig.

Telemedicine and remote care are already being used in parts of Sweden, and this use has increased during the pandemic. Its use within highly specialised care, however, has hitherto been low.

"I actually think that the greatest gains to be made are in highly specialised care – it can sometimes even mean the difference between life and death. When the patients follow the course of their own condition, they also gain greater understanding of the things that affect it and what they can do about it personally", says Frieder Braunschweig.