Due to the advancements of technology, Jenna and I thought it would be beneficial to research current cardiac applications available on our smart phones from the patient’s perspective; HeartDecide was quickly discovered. This free application, available for all Apple products, introduced an all-encompassing cardiovascular easy-to-use tool for patients to understand their respective cardiac anatomy, conditions, and procedures. Although this application was released in 2012 by Orca Health, Inc. at Harvard University, it is continuously updating its information with a copyright date until 2015. Once downloaded, the user has the option of entering the application as a doctor, nurse, or patient. We reviewed the information as if we were a patient, browsing to find a specific medical condition. For instance, we searched “heart attack” via the “conditions” tab and found a simple video lasting 1 minute and 32 seconds. In addition, there are written materials provided after the video by swiping the screen to the left. Here we found a frequently asked question and answer section detailing “what is a heart attack,” “what causes a heart attack,” “what are the symptoms,” and “how is a heart attack treated.” Furthermore, there are numerous conditions available to search such as angina, atherosclerosis, atrial fibrillation, sudden cardiac death, heart failure, and many more. We both believe this to be a great informational tool for patients in order to understand more about their clinical condition.

HeartDecide can be used as a supplemental tool to the education provided by the cardiologist. Often, when patients are newly diagnosed with a cardiac condition or a trauma occurs, they are not able to fully comprehend and/or process the education provided by the clinicians. They can learn great detail about their condition(s) on their own time once they are psychologically prepared to do so. Therefore, we highly recommend this application to all clients with a cardiac condition <3

Recognizing those at risk for CVD is a primary prevention. I found a study that compared a the use of a non-laboratory, paper-based CVD risk assessment chart tool to a mobile phone CVD risk assessment application. The goal was to compare the time it would take to train community health workers, the duration of screening. The paper-based tool was created to avoid laboratory costs; the tool substitutes the body-mass-index for blood lipid level to calculate the CVD risks. This makes screening easier and the best part is that it is cost effective. The development of the mobile device was so it could automatically calculate CVD risks scores with less room for error due to manual calculations and so it could be directly carried into communities. This is an excellent resource that is being used in low-resource settings. The mobile device is also better than the paper-based tool because it can be used by those with a lower set of skills.
The use of the mobile device had some pros and cons. One positive outcome was that it took less time to train personnel in the use of the mobile device compared with the paper-based tool. The mobile device was faster at yielding results. Many of the health care workers felt that there was less room for error because they did not have to manually do calculations. Some cons were that in previous times the visual chart was being used to explain to clients what their results meant. Many also felt that having the detailed chart gave them a better understanding of calculating the risk but with the phone everything was basically done for them.
I really liked this article because it talked about how technology is being used in lower income settings were detecting those at risk for CVD is a high priority. This mobile device it taken into communities, which in my opinion is the way to go because some clients have difficulties with transportation. The device can then calculate the client’s CVD risk and they are then educated or referred to a health care provider. Having a tool that requires little training, has little room for error, and yields quicker results will enhance CVD screening. This is important because the more people that are being screened the more people we can prevent from developing CVD. A con that I would also have trouble with is the fact that the machine is doing everything and when compared to the paper-tool where the calculations were being done and understood by the workers I am not sure how well the workers would understand what the results actually mean when using this technology. The article mentioned that this is being done in South Africa but this would be nice to have in our communities where many are not screened for CVD as a result of more than one obstacle.

References

Surka, S., Edirippulige, S., Steyn, K., Gaziano, T., Puoane, T., & Levitt, N. (2014). Evaluating the use of mobile phone technology to enhance cardiovascular disease screening by community health workers. International Journal Of Medical Informatics, 83(9), 648-654. doi:10.1016/j.ijmedinf.2014.06.008

The CardioMEMS HF System is a small implantable device for patients with heart failure, hypertension, peripheral neuropathy and other additional cardiovascular disorders that eventually result in heart failure. This device was created with the purpose of better managing heart failure in patients from their homes. The CardioMEMS HF is a sensor/ monitor device that is smaller than a dime and does not require any batteries. The device is placed through the distal pulmonary artery. Once home, the patient’s heart rate and artery pressures will be monitored daily by the CardioMEMS HF; on the other side, at a health facility, a physician or nurse will review the information. If there is an abnormality noted then a change to the patient’s medical therapy will be made. Through the use of CardioMEMS HF, the researchers hope to decrease hospitalizations by not having the patients come in to the hospital until they are experiencing severe symptoms from HF. In other words, the aim is to reduce hospitalizations through early interventions.

In regards to my opinion regarding CardioMEMS HF, I think it’s a great idea in that it could possibly decrease hospitalizations through early intervention; however, I find it a bit difficult on how the healthcare workers are going to get in contact with the patient to change the medical regimen when they identify an abnormality. Furthermore, in the case when the patient does have the CardioMEMS HF is implanted I believe that the patient should use standard self-monitoring in conjunction; this includes: self-monitoring of blood pressures.

Below is the link regarding CardioMEMS HF.

http://www.ucsf.edu/news/2014/10/119411/new-miniature-device-monitors-heart-failure-patients-remotely

I chose to look up information on the use of vascular closure devices (Angio-Seal) versus the use of manual pressure following a percutaneous coronary intervention or a CATH procedure. This is a discussion that I had in clinical recently with Lisa. We discussed the use of the Angio-Seal and how it isn’t seen as often. I believe it is preference of the Doctor doing the procedure. According to Gregory, Midodzi, and Pearce (2013) there has been conflicting data about whether the VCD’s decrease, increase, or do not alter the risk of access site complications. The authors had 11, 897 participants. 7, 063 participants received an angio-seal VCD and 4, 834 did not. There were two samples; in the CATH sample 4,845 received a VCD and 4, 030 did not. In the PCI sample, 804 did not receive a VCD and 2, 218 did receive a VCD. Vascular complications rates were lower with both sample groups with the use of VCD. The authors found that the use of VCDs have been associated with earlier ambulation and improved comfort. However, manual compression has been the “gold” standard for 60 years and remains a controversy in whether or not there is any more of a benefit with the use of VCDs. Overall, a low incidence of vascular complications were observed with the use of VCD (angio-seal) in comparison to manual compression (Gregory, Midodzi, & Pearce, 2013).

I found this article interesting and will look further into more research. Because of patient privacy I have chosen not to talk about my situation in clinical with an Angio-Seal versus manual compression.

References

Gregory, D., Midodzi, W., & Pearce, N. (2013). Complicaitons with Angio-Seal vasuclar closure devices compared with manual compression after diagnostic cardiac catheterization and percutaneous coronary intervention. Journal of Interventional Cardiology , 26 (6), 630-638.