Analysis of the organizational impact associated with the use of next-generation insertable cardiac monitors with advanced functionalities in Spain
A Ruiz Duthil, J M Lozano Herrera, M Alvarez, M Crespo, J MonjeAbstract
Introduction
Within the current Spanish cardiology setting, marked by increasing care demand and workforce shortages, the optimization of clinical resources has become a strategic priority. In this context, recent advances in insertable cardiac monitors (ICMs) enable automated patient follow-up and support more efficient clinical workflows.
Purpose
To estimate the organizational impact, measured in terms of personnel time savings, associated with the use of next-generation ICMs at a tertiary care center.
Methods
A comparative analysis was conducted over a three-year time horizon, evaluating the current hospital setting where patients were monitored using two generations of ICMs from the same technological line (55% older generation and 45% latest generation), in comparison with a hypothetical scenario in which all patients were monitored using the latest-generation model. The target population was estimated based on the number of patients under follow-up, applying the annual rate of new implants and decommissioned devices. Functional differences between device generations were considered, including automatic data transmission, remote reprogramming, and mobile app compatibility for remote monitoring. Both ICMs included artificial intelligence algorithms, patient phone support service and tablet-based management solution. These features defined the clinical activities associated with each device. Resource consumption and time required per activity (ICM implantations, remote reprogrammings, remote transmission reviews for atrial fibrillation and pauses, in-person visits, manual transmissions, and phone calls) were obtained from both the literature and hospital’s clinical practice. All parameters were validated by a national electrophysiology specialist at the center. A sub-analysis of the activity over the last 4-month period prior the submission was performed estimating the number of remote transmissions reviews, based on hospital data from 258 patients monitored.
Results
It was estimated that 342, 392, and 440 patients were monitored in the first, second, and third year, respectively. Fully transitioning to the most advanced ICM model could lead to a reduction of 726 remote transmission reviews (−15%), 84 in-person visits (−30%), 1,169 manual transmissions (−100%), and 22 phone calls (−3%). This would translate into a total saving of 273 hours of clinical workload (equivalent to 34 working days). The sub-analysis of the activity showed a greater impact, with 7,337 fewer transmissions (−80%), resulting in 1,518 hours saved (equivalent to 190 working days) and reflecting the improvement in detection algorithms.
Conclusions
The advanced functionalities of ICMs enable a significant reduction in clinical staff time, thereby facilitating a more efficient reorganization of healthcare workflows.Total number of activities per year.Staff hours required by activity & year