Telecardiology for patients with acute or chronic cardiac complaints: The 'SHL' experience in Israel and Germany

Objective: To assess the impact of a telemedicine program in which electrocardiogram (EKG), body weight and/or blood pressure are measured at home and medically trained personnel judge the transmitted data and council the patients by telephone. Method: We systematically studied the outcome and cost-effectiveness of the cardiac programs carried out by Shahal (SHL) during the past 19 years. Result: Most patients (85%) with acute complaints resembling coronary artery disease, could be reassured, representing a savings of about 46 677 000 per 10 000 members/yr in Israel in., 1989, and a marked reduction in patient delay to 44 min (median). In chronic heart failure a 66% reduction in hospitalisation days was observed, together with an improvement in quality of life. A large Healthcare Insurance Company in Germany (Taunus BKK) has calculated that it can save at least E 5 million per year with the use of such services. Conclusion: Disease management with concomitant telemedicine for coronary artery disease and chronic heart failure is safe and effective and has a huge potential for cost savings, improvements in quality of life and in prognosis of heart disease. (c) 2006 Elsevier Ireland Ltd. All rights reserved.