Professor Jean Cassagnes, Cardiauvergne : « teleassistance has reduced heart failure patient mortality by half »

Points de vue | 07 Oct 2014
Professor Jean Cassagnes is a cardiologist, a university professor, and former head of the CHU Department of Cardiology in Clermont-Ferrand. Since 2010, he has founded and led the GCS Cardiauvergne, an organization proposing a telemonitoring service for heart failure patients. (He founded the GCS Cardiauvergne in 2010 and has since led this organization proposing a telemonitoring service for heart failure patients.) Results

Can you briefly present the GCS Cardiauverge and its objectives?


Cardiauvergne is a healthcare cooperation grouping (GCS of 35 partners) which proposes remote monitoring service and care coordination for patients with heart failure. It is important to know that heart failure is a serious and frequent illness: the odds of survival after 5 years of illness are only 35%; the disease affects 2% of the French population and involves 25 000 people in just Auvergne. Moreover, 120 000 new cases are “generated” each year following a myocardial infarction, and 35 000 people die every year.

The first objective of Cardiauverge is therefore to better the vital prognosis of heart failure patients by improving their medical care through remote monitoring.

The goal is also to reduce hospitalizations and to keep patients at their homes the longest time possible. In fact, heart failure is the leading cause of hospitalization of citizens aged 60 or older in France, with more than 220 000 stays per year. It is therefore a major public health issue. .


 

How do digital tools help you improve the lives of the ill? 


Once the patient has the device, the patient is given a personal connected scale, which will measure and report daily weight to us.  A rapid weight gain informs us quite clearly on the patient water and salt retention, and the possible formation of edema. Beyond a certain threshold (2kg), we receive an alert and choose a response. Often, a simple telephone call is enough to reassure us, but if the case is more severe, we can contact the nurse or the private practitioner so they can assist the patient at home. 


These nurses, members (adherents) of GCS received a smartphone (400 smartphones financed by the general council in the Auvergne region were distributed) and downloaded the application, from which they can transmit, from a distance, information (elements) on the clinical status of the patient.

Thanks to the connection via secure messaging with regional pharmacies, this information feeds to the electronic file, which compiles biological analysis results as well as patient treatments. 





The personal scale used to follow patient progress in the Cardiauvergne project. 

What results did you achieve ? 


Quantitatively, we have halved heart failure mortality and reduced by nearly two-thirds the rate of rehospitalization on the first 558 patients enrolled and monitored for an average of one year. Already a great success! However, in an unexpected way, we found a qualitative impact on all health professionals involved: they feel more useful because of this new coordination. Lastly, and what might be most important, is that patients are pleased (delighted, happy) because they feel very safe. Moreover, they are worried and would like the continuation of this pilot program, which survives today thanks to grants from the ARS, the State, and the European Union. Unfortunately, there still lacks a financial structure to sustain the project.

Do you think the « qualified self » applications can be beneficial (a plus) for patients?


Yes, it can undeniably be a plus for patient monitoring, on the condition that they be monitored by a doctor and share their information with him. In fact, currently these tools seem mostly used by people in good health, thus it should not be that it generates more anxiety than prevention. 

Moreover, with  Almérys,the society which accompanies us on the technical aspects, we are working on the project « Cardiauvergne 2”, in which patients would be wearing a connected shirt, capable of transmitting their information such as body temperature, cardiac frequency, respiratory frequency, and physical activity level. 


Further information (in french) :