Telemonitoring for Chronic Heart Failure: A 20-Year Journey from Concept to Standard Care in Germany (Preprint)

Abstract

Chronic heart failure (CHF) is a leading cause of morbidity and mortality worldwide, with a significant burden on healthcare. The concept of telemedicine for CHF was first proposed in the late 1990s, and since 2010, studies have demonstrated its potential to improve patient outcomes and reduce healthcare costs. Over the following decade, technologic advances and changes in healthcare policy led to the development of more sophisticated telemedicine solutions for CHF, including remote patient management (RPM) using invasive or non-invasive telemonitoring devices, mobile applications, and virtual consultations. Many years of public funding in Germany have provided evidence that RPM improves CHF patient outcomes, such as quality of life, and reduces hospital admissions. Based on this data, the Federal Joint Committee (G-BA) decided, independently of current European Society of Cardiology (ESC) recommendations, to include telemedicine as a digital intervention for high-risk patients with reduced left ventricular ejection fraction in standard care in Germany in 2020. The aim of this review is to illustrate the journey from the initial idea through pioneering studies that led to its implementation into standard care and to report on current experiences that have made Germany one of the leading countries in the field of cardiovascular telemedicine