Cost effectiveness of medtronic carelink express device usage in emergency department


Aurora Cardiovascular Services

Aurora Sinai/Aurora St. Luke’s Medical Centers

Aurora Research Institute

Presentation Notes

Poster presented at: Heart Rhythm Scientific Sessions; May 17, 2017; Chicago, IL.


BACKGROUND: Patients with Medtronic devices presenting to emergency department (ED) need interrogation of the device. Manual interrogation via on-call personnel may take time, increase direct cost to the patient and increase the overflow in the ED. CareLink Express (CLE) technology allows automatic interrogation in the ED that will be interpreted instantly electronically.

OBJECTIVE: Direct cost effectiveness to patients using this new technology was evaluated.

METHODS: In 12 months there were 147 consecutive patients with Medtronic devices (61-84 years old, 62.3% males) who came to ED for interrogation. The first 6 months, the patients were interrogated via traditional method (60 patients). The following 6 months, CLE was used (54 patients). Demographics, comorbidities, diagnosis, device findings, admission, reprogramming, length of stay (LOS) in ED, cost and follow-ups were compared between the groups.

RESULTS: Demographics were similar between groups. Comorbidities including chronic kidney disease, diabetes, hypertension, dyslipidemia, congestive heart failure, coronary artery disease and history of coronary artery bypass grafting also were similar. There was no difference in diagnosis category. Both groups had similar device interrogation findings (64.5% vs. 72.1% normal, p=0.33). The use of CLE did not affect the decision for hospital admission (45.6% vs. 53.2%, p=0.36), nor rate of reprogramming (7.4% vs. 13.9%, p=0.2). Median follow-up with out-patient cardiology clinic was the same in both groups (23 vs. 33 days, p=0.35). The use of CLE significantly shortened the LOS in ED (185.2±63.1 vs. 229.8±81.7 min, p

CONCLUSIONS: CareLink Express facilitates shorter LOS in the ED for patients with Medtronic devices with significant cost effectiveness to the patient without compromising the decision for disposition or follow-up.

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