Substantial preparative work has been made, and the development of the eCardiacRehab is informed by published work from our CONCARDPCI study (3400 patients enrolled), including a systematic review on modes of eHealth delivery in secondary prevention programmes for patients with coronary artery disease, qualitative interview studies, and quantitative studies.
Cardiac rehabilitation (CR) is a class I recommendation in European and American guidelines as it reduce mortality, readmissions, and psychological distress, and improve self-management, health related quality of life and physical capacity in patients with coronary artery disease. In Norway, more than 12,000 patients undergo PCI every year.
Despite better treatment methods, these patients live with a chronic heart disease with implications for patients, clinicians, healthcare systems and the society. The majority of these patients (70-80%), are offered no CR due to high patient volume and few CR programmes. Furthermore, the rapid development of COVID-19 has provoked a need to re-think modes of healthcare delivery and to move beyond traditional place-based CR and embrace electronic health resources that connect care through the internet and related technologies. The eCardiacRehab project will make CR available to all patients undergoing PCI by taking advantage of new technological solutions and collaboration across different disciplines.
The innovative eCardiacRehab can meet the rehabilitation needs of large patient groups, regardless of their access to traditional place-based CR. eCardiacRehab is a person-centred eHealth programme moving health services from hospital to home aimed at guiding patients’ self-management and prevention of coronary artery disease. Patients will be offered eCardiacRehab after referral from a physician. eCardiacRehab will be accessible via a secure (safety level 4) and password-protected internet site for use on a computer, smartphone or tablet. We work closely with the section for eHealth and Helse Vest IKT in development of the digital solution. In addition, eCardiacRehab provides secure digital communication between patient and healthcare provider.
We have emphasized user involvement in the planning and design of the eCardiacRehab. The educational and informational materials offered in the eCardiacRehab programme includes tailored counselling, and health information according to patients' preferences, e.g., written material adapted to appropriate reading level, and use of visual elements and videos. The eCardiacRehab is developed in an interdisciplinary team to ensure that the information material is research-based and up-to-date.
eCardiacRehab has the potential to improve interaction and collaboration between primary and secondary care, modernise and digitalise work processes, and to develop more coherent and tailored patient pathways. All of which are focus areas in the national eHealth strategy (Nasjonal e-helsestrategi 2017-2022) and the Helse Vest strategy to develop the patient’s healthcare services (Helse2035). Furthermore, eCardiacRehab will reduce the variation in quality and availability of CR and improve patient pathways.