Marzegalli M et al. 2008 "Remote monitoring of CRT-ICD: the multicenter Italian CareLink evaluation - ease of use, acceptance, and organizational implications."

Marzegalli M, Lunati M, Landolina M, et al. Remote monitoring of CRT-ICD: the multicenter Italian CareLink evaluation - ease of use, acceptance, and organizational implications. Pacing Clin Electrophysiol 2008;31(10):1259-1264.
"PURPOSE: The [telemedicine system] allows remote implantable device follow-up. In this first European experience with [this system], we assessed the ease of use of the system, the acceptance, and satisfaction of patients and clinicians. METHODS: Patients implanted with biventricular defibrillators for more than 6 months received the [system] monitor and were trained to perform home device interrogation and transmission. Patient and clinician experience and preference were evaluated through specific questionnaires. RESULTS: Sixty-seven patients were enrolled and were able to perform data transmissions during the 3-month study duration. The overall duration of interrogation procedure was 7 +/- 5 minutes, and frequently the procedure did not require the assistance of a caregiver. Patients reported a general preference for remote versus in-clinic follow-up and described a sense of reassurance created by the remote monitoring capability. In the centers, the review procedure was successful; its mean duration was 5 +/- 2 minutes per transmission and the users indicated that the access and navigation of the review website were easy. At the end of the evaluation, the data available for remote review were judged complete and adequate to provide almost the same standard of care as that offered in traditional in-clinic visit. In general, the remote monitoring was seen as a potential tool to improve the clinical management of patients with device. CONCLUSIONS: The ease of use, satisfaction, and acceptance of the [telemedicine system] in European clinical practice appears elevated both for patients and for clinicians."

"(1) To evaluate the ease of use of the system by the patient and the clinician; (2) To evaluate their acceptance and satisfaction with the monitor and with reviewing device data via the website."

Tools Used
Type Clinic
Specialty care
Other Information
Five clinics participated in the study.
Type of Health IT
Type of Health IT Functions
The implanted biventricular defilibrator device includes a patient monitor to interrogate the implanted device and send the information to the secure network server via the telephone connection. Clinicians can review device information on an Internet-accessible Web site.
Context or other IT in place
The context varied across practices.
Workflow-Related Findings
Using telemedicine and transferring data remotely saves travel time for patients and fewer clinic visits. Furthermore, the system greatly reduces unscheduled clinic visits. Cost savings were estimated at nearly 200 Euro per year.
The majority of clinicians found it easy to access and navigate the Web site for patient review.
Clinicians agreed that using telemedicine and the devices may improve management of scheduled and unscheduled visits.
Study Design
Only postintervention (no control group)
Study Participants
Sixty-seven patients and 32 clinicians participated.