Integrated heart failure care in multiple European regions

Background: In co-creation with patients and multidisciplinary care teams we developed an integrated care solution for heart failure patients on the Viduet platform that is implemented in three European regions for the TIQUE-PCP project.

Approach: TIQUE-PCP, a project funded by the European Union, seeked a groundbreaking, tech-driven, integrated care solution for Advanced Heart Failure that enables predictive, preventive and participatory care - ensuring qualitative care at the optimal location. Based on the input of caregivers from multidisciplinary care teams and patients, we developed an integrated care solution that can be used to empower patients. Using the concept of Viduet action plans, patients are supported to use the outcomes of home measurements and symptom trackers to recognize decompensation and take appropriate action. Healthcare professionals are also informed when symptoms of decompensation are detected.

We started in The Netherlands, where the Viduet platform was initially piloted in order to help chronic heart failure patients and their caregivers by designing a specific integrated carepath. During the projects, Viduet listened to the needs of several cardiologists, nurses, general practitioners and heart failure patients. With that input, a heart failure solution was created on the Viduet platform in which caregivers from different care levels collaborate around the patient via the Viduet platform. Patients can be easily referred between primary and secondary care organizations, which encourages multidisciplinary collaboration. Viduet helps healthcare providers spend their time as efficiently as possible by aligning the work of multiple levels of caregivers.

For TIQUE, Viduet will pilot the Viduet platform for integrated heart failure care in, Barcelona (Spain), Avellino (Italy), and Västerbotten (Sweden). With these pilots we will co-create tailored care pathways in collaboration with different local healthcare providers like medical specialists, nurses, homecare organizations and patients, ensuring the solution is customized to meet each region's unique needs. The platform will encourage different levels of healthcare providers to join forces to ensure the patients wellbeing.

Results: In the Dutch pilots, the Viduet platform has reduced the need for in-person consultations through effective remote monitoring, and saved time across care teams by optimizing data-sharing and patient management. This efficiency allows healthcare providers to focus more directly on patient needs, improving overall care delivery and patient satisfaction. Patients feel more in control of their health, which encourages them to raise concerns earlier and take action to prevent further health decline.

For the TIQUE pilots, the heart failure care paths with Viduet will be tailored uniquely for each region, with customizations that address specific local needs. By collaborating closely with local healthcare organizations and patients, Viduet will ensure that the platform integrates seamlessly with each region's own care pathways, facilitating optimal support for heart failure management across diverse healthcare settings.

Implications: In May, we expect to have included the patients into Viduet in all three countries, have received feedback from both patients and their different levels of caregivers and adjusted the platform to their particular needs. This validation process will help ensure the integrated care pathway becomes even more effective in each region.