James Allred, MD — CV Remote Solutions
In many cardiology practices, the number of heart failure patients being remotely monitored is considerably smaller than the number who could potentially benefit from it.
The patients are already there. Many already have implanted devices capable of collecting meaningful diagnostic information. The data exists.
What is often missing is the operational capacity to do something with it.
That is rarely a question of whether clinicians see value in monitoring fluid trends, arrhythmia burden, or other indicators of worsening heart failure between visits. The challenge is more practical: turning on another monitoring workflow means someone has to review the data, manage the alerts, communicate findings, document the work, and make sure clinically meaningful information reaches the right person.
Which makes it, in many ways, a staffing question wearing a clinical question’s clothes.
And staffing questions have answers that don’t always require hiring.
What the practice gains
The clinical case for remote heart failure management has been extensively studied, including in the 2023 JACC Scientific Statement on Remote Monitoring for Heart Failure Management at Home.
For the teams responsible for actually running these programs, the value is practical:
- Earlier visibility into worsening status. Remote monitoring can identify changes between visits that may warrant clinical review before overt decompensation occurs. Patients hospitalized for heart failure continue to face a substantial risk of rehospitalization in the months that follow, making that window particularly important.
- More data between visits. Longitudinal diagnostic information gives clinicians additional context when evaluating symptoms, treatment response, and potential changes in a patient’s condition.
- Better continuity between encounters. Remote monitoring helps extend the clinical team’s visibility beyond scheduled appointments, creating an opportunity to identify meaningful changes while the patient is still at home.
- A more connected patient experience. A well-designed monitoring program gives patients a clearer connection to their care team between visits and a defined pathway for responding when their condition changes.
The clinical rationale is not usually where programs get stuck. The operational reality is.
What it actually costs your team
We studied the workload associated with CIED remote monitoring because surprisingly little published data described what it demands ofexisted on what this work actually requires from clinical teams.
Our research found that reviewing a single remote transmission from a therapeutic device consumes approximately 9.4 to 13.5 minutes of clinical staff time. Beyond transmission review itself, monitored patients generated additional time related to calls, troubleshooting, triage, scheduling, and other work surrounding the remote monitoring program.
Those findings were specific to CIED remote monitoring, but they illustrate a larger point that applies when practices consider expanding into heart failure monitoring:
Remote monitoring is not passive.
Every new stream of clinical information creates work. Someone has to receive it, review it, determine what matters, route it appropriately, and close the loop.
Multiply that work across a patient panel and across an entire year, and the operational requirement becomes significant.
Adding heart failure monitoring to an already-full clinical team’s workload without defining who will own that work is how promising programs struggle to scale.
Naming the workload honestly is the first step.
The second is deciding who absorbs it.
Who does what?
A sustainable heart failure monitoring program requires clear ownership.
With our In the CV Remote Solutions model, much of the operational workload can sit outside the practice while the clinical decision-making remains exactly where it belongs.
CV Remote Solutions can support:
- Patient enrollment and education
- Monitoring schedules and workflow management
- Disconnected-monitor management
- Technical review of transmissions and diagnostic data
- Identification and routing of clinically relevant findings
- Preparation of information for physician review and sign-off
The practice maintains responsibility for:
- Clinical decision-making
- Medication and care-plan changes
- Communication of clinical recommendations to the patient
- Physician review and sign-off when required
Your team stays in the loop without having to live in the queue.
That distinction matters.
The opportunity many practices leave on the table
Heart failure remote monitoring also has an established reimbursement pathway for eligible patients and services when applicable billing requirements are met.
For practices already caring for a substantial population of patients with heart failure, particularly those with implanted devices generating useful diagnostic information, that creates an opportunity to pair better visibility between visits with a financially sustainable clinical workflow.
But reimbursement alone does not make a program successful.
The work still has to be done.
The question is whether that work will be absorbed by a team that is already at capacity or supported by a workflow designed specifically to handle it.
Before deciding that heart failure monitoring is too difficult to implement, it is worth understanding three numbers:
How many patients could qualify?
How much work would monitoring them create?
Who would own that work?
Those answers usually make the path forward much clearer.
Build enrollment into the workflow
The most sustainable programs do not rely on someone in the clinic remembering to identify the next patient who should be offered heart failure remote monitoring.
Instead, they establish an agreed-upon enrollment trigger.
That trigger might occur when an eligible device is implanted, when a patient reaches a defined point in their care pathway, or when another predetermined clinical criterion is met. Once the trigger occurs, the enrollment workflow begins automatically.
This matters because even successful pilot programs can stall. A practice may enroll an initial cohort, prove that the model works, and still struggle to expand simply because identifying and enrolling the next group of patients remains another task on an already-full clinical team’s list.
A defined trigger changes that.
It allows CV Remote to own more of the enrollment workstream, identifying patients who meet the agreed-upon criteria, initiating the enrollment process, educating patients, and moving them into the monitoring workflow, while the practice retains control over the clinical criteria that determine who should be offered the program.
The goal isn’t simply to start a heart failure monitoring program.
It’s to build an enrollment process that continues to work when no one is thinking about it.
If you’d like to understand how many patients in your practice may be candidates for heart failure remote monitoring — or talk through what a first cohort could look like — contact CV Remote Solutions at info@cvremotesolutions.com.
References
Stevenson L, Ross H, Rathman L, et al. Remote Monitoring for Heart Failure Management at Home: JACC Scientific Statement. J Am Coll Cardiol. 2023;81(23):2272–2291.
Seiler A, et al. JMIR Cardio. 2021;5(2):e27720.