MDNews - Minnesota

"I ca nnot oversell the impor ta nce of adva nced practice prov iders who see patients day-in a nd day-out," Dr. Ernst says. "A s hea r t fa ilure physicia ns, we consider reg ula r in-clinic monitoring an integra l par t of care. Having routine v isits w ith the sa me indiv idua ls a nd creating relationships with them help keep patients from feeling overwhelmed by the volume of information they need to know about ma nag ing their condi- tions. Our nurses k now patients li ke fa m i ly member s — t hey k now t hei r habits, tendencies, diets a nd levels of understa nding. This provides a sa fet y net for patients. They have someone who understa nds them, ha s a relationship with them a nd knows what to do if they sta r t having problems. We encourage ou r pat ient s t o use us a s a resou rce rather tha n the emergency room if at a ll possible. " EMBRACING TECHNOLOGY A s t he C.O. R . E . C l i n ic t e a m a nd patients' prima r y ca re providers work to optimize ca re, remote monitoring ca n be a huge asset. Access to a readily ava i lable suppor t net work of prov id- ers plays a la rge role in deter mining whether or not patients' treatment plans are effective. The C.O.R .E. Clinic relies on telema na gement to prov ide close, individua l monitoring for individua ls who a re at home. A t oucht one t elephone ser v ic e i s the cornerstone of the C.O.R .E. Clinic telemanagement program. This system a llows patients to record their weight as well as answer other basic symptom- related questions. "If their weight is outside designated pa ra meters or if their sy mptoms a re becom i ng worse for a ny rea son, ou r nurses enga ge w ith patients over the phone to d iscuss what is happen i ng a nd ascer tain why the situation may be worsening," Dr. Ernst says. "Oftentimes, we ca n ma ke t hat a ssessment a nd a necessa r y adjustment w it hout ma k- ing patients come into the of f ice. We may need to cha nge their medications over the phone. The telema na gement program a lso helps a lert us if the patient needs to come to the clinic for an urgent v i s it . T he ide a l pa t ient for r emot e monitoring is one who is motivated to be compliant with medications, but may str ugg le w ith ma na g ing their condi- tions. These a re the t y pes of patients who end up hospita li zed f requent ly, despite the fact that conser vative ca re mea sures may be more appropr iate. This program can provide more insight a s t o why c ont i nue d r e a d m i s s ion s a re ta king place, a nd, hopef u l ly, help reverse the trend." For those in need of more adva nced remote monitoring, the C.O.R .E. Clinic offers options such as the CardioMEMS H F S y s t e m . T h i s s y s t e m u s e s a n i mpl a nt e d s e n s or t o m e a s u r e a n d monitor pulmonary artery pressure and heart rate. Measurements are sent to the clinic on a daily basis, a llowing the care team to better eva luate hemodynamics a nd of fer t reat ment before pat ient s become symptomatic. From left to right: Eric R. Ernst, MD, FACC, Medical Director of the University of Minnesota Health C.O.R.E. Clinic; Kristine Mannchen, MSN, CNP, Program Director; and Sara More, PA-C, MS, BS 0 8 0 8C O V E R F E A T U R E

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