Heart failure is the most rapidly rising cardiovascular disease in Canada, currently affecting more than 1 million people nationally, and with more than 50,000 new diagnoses annually. A complex chronic condition, people living with heart failure face symptoms of shortness of breath, swelling in the lower limbs, and fatigue, as well as frequent flare-ups often leading to hospital admission. The journey that follows heart failure diagnosis is undeniably challenging and for many, life altering.
Heart failure management requires patients to take an active role in their care by maintaining a low-sodium diet, restricting fluids and taking their medication as prescribed. Guideline directed care is a cornerstone of therapy. A major challenge in care is the lack of access to heart failure specialists. Currently, in Canada, clinics are facing high patient volumes that cannot be supported with traditional patient visits alone.
Within the Heart Failure Clinic at University Health Network’s Peter Munk Cardiac Centre , one program is helping pave the way to transform how care is delivered for heart failure patients and reduce the burden on the health system, and most importantly the patients themselves.
Medly, a heart failure management program,developed by the teams at UHN’s eHealth Innovation, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, is a first of its kind in Ontario and Canada. Medly is unlike traditional telemonitoring programs with its use of the Medly management algorithm, developed by heart failure clinicians to rapidly assess and triage patients, and the creation of a new role in the heart failure care delivery model: a Medly coordinator role.
Mary O’Sullivan, a registered nurse and the Medly coordinator at the Peter Munk Cardiac Centre, currently manages nearly 300 heart failure patients, a patient volume not typical of such a role. For Mary, her patient load is made possible and has the potential to grow with the support of the Medly Program.
“I am able to connect and give nursing care to patients across the province each day,” Mary says. “ Medly provides a platform for such a unique nurse-patient relationship. It allows me to gain insight into how their heart failure management fits into their daily lives and enables me to interact with patients in their own environment and develop long-term relationships with them. This personal element enhances the way that I assess, triage and provide education for these patients.”