Heart failure patient

Heart failure is characterized by high rates of hospital readmission, elevated mortality, and poor long-term prognosis, resulting in significant healthcare expenditures. To address these challenges, we have developed a patient-centered Cloud-Based Heart Failure Care Platform by integrating the FileMaker system with our healthcare network’s Family Health Cloud Platform. This platform enables intelligent monitoring, interdisciplinary medical interventions, and precise analysis of clinical indicators, thereby enhancing patients’ quality of life, reducing readmission rates, and improving cardiac systolic function and biochemical markers. By streamlining data integration within the system, we have significantly reduced the need for manual data processing, alleviating the clinical workload of healthcare team members. Furthermore, the platform leverages social media and wearable devices to create a community-centered care model, providing heart failure patients with accessible educational content and physiological monitoring tools. In addition, the platform establishes a bidirectional communication channel between community-based patients and hospital care teams. This model addresses three major challenges commonly faced in rural areas: 1. A high proportion of elderly patients with limited self-care capacity, 2. Inadequate family support systems that hinder timely assistance, and 3. Increasing care burdens on medical staff.

Establishment of a patient-centered "Cloud-based Heart Failure Care Platform" to achieve intelligent monitoring and multidisciplinary team intervention.

The platform provides care to an average of 10-20 patients each month.

• The average KCCQ (Kansas City Cardiomyopathy Questionnaire) score, reflecting quality of life, improved significantly from 48.1 at baseline to 115.1 post-intervention.

• The mean Left Ventricular Ejection Fraction (LVEF) increased from 31.8% at baseline to 43.1% after receiving care.

• Average BNP levels decreased from 1,230 pg/mL pre-intervention to 546 pg/mL post-intervention.

• Reduce readmission rate and medical costs.

• Improving patients' quality of life and sense of security.

The evaluation covered several dimensions, including the convenience of remote tracking, the comprehension of patient education materials, and overall care satisfaction. Statistical results indicate that the majority of surveyed patients gave ratings of 4.8 or higher across various indicators. The overall average score has consistently remained above 4.0, reflecting a high level of patient satisfaction.

• There has been a significant reduction in patient readmission rates.

• The integration of cloud-based home monitoring and real-time responses from case managers has effectively minimized delays in patients seeking medical attention.