Advances in Technology Promote Patient-Centered Care in Cardiac Rehabilitation.

Patient-centered health care (PCC) is a framework of clinical care focused on the patient's individual health care needs. In particular, it emphasizes the development of a partnership between the patient, physician, and healthcare workers to actively involve and empower the patient in their health care decisions. Additionally, PCC goals include ensuring access to care, emotional support, engaging patient support systems, physical comfort, and continuity of care. Technology also provides a platform to engage patients and their families in their care and can be a useful tool to gauge their level of interest, knowledge, and motivations to adequately educate them on the many factors that contribute to their disease, including diet, exercise, medication adherence, psychological support, and early symptom detection. In this article, we summarize the importance of technology in promoting PCC in cardiac rehabilitation and the impact technology may have on the different aspects of patient and physician relationships. Modern technological devices including smartphones, tablets, wearables, and other internet-enabled devices have been shown to help patient-staff communication, cater to patients' individual needs, increase access to health care, and implement aspects of PCC domains.

[1]  D. Forman,et al.  Digital Technologies in Cardiac Rehabilitation: A Science Advisory From the American Heart Association , 2023, Circulation.

[2]  T. Gorely,et al.  Barriers and facilitators to participating in cardiac rehabilitation and physical activity: A cross-sectional survey , 2022, World journal of cardiology.

[3]  S. Ooi,et al.  A Smartphone-Based Model of Care to Support Patients With Cardiac Disease Transitioning From Hospital to the Community (TeleClinical Care): Pilot Randomized Controlled Trial , 2022, JMIR mHealth and uHealth.

[4]  S. Chair,et al.  Effectiveness of technology-assisted cardiac rehabilitation: A systematic review and meta-analysis. , 2021, International journal of nursing studies.

[5]  T. Gorely,et al.  Transitions in Technology-Mediated Cardiac Rehabilitation and Self-management: Qualitative Study Using the Theoretical Domains Framework , 2021, JMIR cardio.

[6]  B. Cieślik,et al.  Evaluation of the Impact of Virtual Reality-Enhanced Cardiac Rehabilitation on Depressive and Anxiety Symptoms in Patients with Coronary Artery Disease: A Randomised Controlled Trial , 2021, Journal of clinical medicine.

[7]  Sara Sotirakos,et al.  Harnessing artificial intelligence in cardiac rehabilitation, a systematic review. , 2021, Future cardiology.

[8]  P. Taub,et al.  Cardiac Rehab in the COVID Era and Beyond: mHealth and Other Novel Opportunities , 2021, Current Cardiology Reports.

[9]  Joanna Szczepanska-Gieracha,et al.  Immersive Virtual Reality Therapy as a Support for Cardiac Rehabilitation: A Pilot Randomized-Controlled Trial , 2021, Cyberpsychology Behav. Soc. Netw..

[10]  Ingrid M. Nembhard,et al.  A Systematic Review of Surveys for Measuring Patient-centered Care in the Hospital Setting. , 2020, Medical care.

[11]  Á. Thoroddsen,et al.  Impact of technology-based patient education on modifiable cardiovascular risk factors of people with coronary heart disease: A systematic review. , 2020, Patient education and counseling.

[12]  Brian Vadasz,et al.  Feasibility, Safety, and Effectiveness of a Mobile Application in Cardiac Rehabilitation. , 2020, The Israel Medical Association journal : IMAJ.

[13]  H. Torp,et al.  Feasibility and Accuracy of Tele‐Echocardiography, With Examinations by Nurses and Interpretation by an Expert via Telemedicine, in an Outpatient Heart Failure Clinic , 2020, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[14]  C. Pagé,et al.  Telerehabilitation with live-feed biomedical sensor signals for patients with heart failure: a pilot study. , 2019, Cardiovascular diagnosis and therapy.

[15]  Theresa M. Beckie,et al.  Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. , 2019, Journal of the American College of Cardiology.

[16]  C. Kuziemsky,et al.  Using Patient and Family Engagement Strategies to Improve Outcomes of Health Information Technology Initiatives: Scoping Review , 2019, Journal of medical Internet research.

[17]  G. Elwyn,et al.  The impact and utility of encounter patient decision aids: Systematic review, meta-analysis and narrative synthesis. , 2019, Patient education and counseling.

[18]  B. Freedman,et al.  Telehealth interventions for the secondary prevention of coronary heart disease: A systematic review and meta-analysis , 2019, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[19]  G. Bartlett,et al.  Support for teams, technology and patient involvement in decision-making associated with support for patient-centred care. , 2018, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[20]  Nicholas Gant,et al.  Effects and costs of real-time cardiac telerehabilitation: randomised controlled non-inferiority trial , 2018, Heart.

[21]  M. Rubio-Valera,et al.  Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies , 2018, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[22]  G. Hillis,et al.  The effects of a lifestyle-focused text-messaging intervention on adherence to dietary guideline recommendations in patients with coronary heart disease: an analysis of the TEXT ME study , 2018, International Journal of Behavioral Nutrition and Physical Activity.

[23]  H. Kusnanto,et al.  Biopsychosocial model of illnesses in primary care: A hermeneutic literature review , 2018, Journal of family medicine and primary care.

[24]  Brian A Primack,et al.  Telehealth Protocol to Prevent Readmission Among High-Risk Patients With Congestive Heart Failure. , 2017, The American journal of medicine.

[25]  J. Alpert,et al.  Patient-centered communication in digital medical encounters. , 2017, Patient education and counseling.

[26]  J. Merrill,et al.  Technology Solutions to Support Care Continuity in Home Care: A Focus Group Study , 2017, Journal for healthcare quality : official publication of the National Association for Healthcare Quality.

[27]  K. Turner,et al.  Patients’ and nurses’ views on providing psychological support within cardiac rehabilitation programmes: a qualitative study , 2017, BMJ Open.

[28]  Alan D. Lopez,et al.  Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015 , 2017, Journal of the American College of Cardiology.

[29]  J. Marcin,et al.  Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association. , 2017, Circulation.

[30]  Krishnaswamy Chandrasekaran,et al.  Improving Health Outcomes Through Patient Education and Partnerships with Patients , 2017, Proceedings.

[31]  Alberto Ruano-Ravina,et al.  Participation and adherence to cardiac rehabilitation programs. A systematic review. , 2016, International journal of cardiology.

[32]  C. Celano,et al.  Anxiety Disorders and Cardiovascular Disease , 2016, Current Psychiatry Reports.

[33]  J. A. Snoek,et al.  Rationale and design of a randomised clinical trial for an extended cardiac rehabilitation programme using telemonitoring: the TeleCaRe study , 2016, BMC Cardiovascular Disorders.

[34]  Véronique A. Cornelissen,et al.  Cardiac patients show high interest in technology enabled cardiovascular rehabilitation , 2016, BMC Medical Informatics and Decision Making.

[35]  Alison M. Hutchinson,et al.  Engaging patients and families in communication across transitions of care: an integrative review protocol. , 2016, Journal of advanced nursing.

[36]  R. Engel,et al.  Increasing self-knowledge: Utilizing tele-coaching for patients with congestive heart failure , 2016, Social work in health care.

[37]  M. Izadi,et al.  Cardiac rehabilitation using the Family-Centered Empowerment Model versus home-based cardiac rehabilitation in patients with myocardial infarction: a randomised controlled trial , 2016, Open Heart.

[38]  A. Evangelista,et al.  Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation , 2016, Heart.

[39]  Davina Banner-Lukaris,et al.  Randomized trial of a virtual cardiac rehabilitation program delivered at a distance via the Internet. , 2014, Circulation. Cardiovascular quality and outcomes.

[40]  F. Whittaker,et al.  The costs and benefits of technology-enabled, home-based cardiac rehabilitation measured in a randomised controlled trial , 2014, Journal of telemedicine and telecare.

[41]  Marlien Varnfield,et al.  Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial , 2014, Heart.

[42]  Joy C MacDermid,et al.  Scoping review of patient-centered care approaches in healthcare , 2014, BMC Health Services Research.

[43]  J. Kvedar,et al.  Connected health: a review of technologies and strategies to improve patient care with telemedicine and telehealth. , 2014, Health affairs.

[44]  H. Thimbleby Technology and the Future of Healthcare , 2013, Journal of public health research.

[45]  Yoshimi Fukuoka,et al.  Using Mobile Technology for Cardiac Rehabilitation: A Review and Framework for Development and Evaluation , 2013, Journal of the American Heart Association.

[46]  Suzanne Austin Boren,et al.  Patient-Centered Care and Outcomes , 2013, Medical care research and review : MCRR.

[47]  G. Nijpels,et al.  Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia , 2013, Diabetes Care.

[48]  J. Sweeney,et al.  Patient and family engagement: a framework for understanding the elements and developing interventions and policies. , 2013, Health affairs.

[49]  Jodi G. Daniel,et al.  A national action plan to support consumer engagement via e-health. , 2013, Health affairs.

[50]  Chris Blanchard,et al.  Randomized trial of an internet-based computer-tailored expert system for physical activity in patients with heart disease , 2012, European journal of preventive cardiology.

[51]  M. Barry,et al.  Shared decision making--pinnacle of patient-centered care. , 2012, The New England journal of medicine.

[52]  Warner M Mampuya,et al.  Cardiac rehabilitation past, present and future: an overview. , 2012, Cardiovascular diagnosis and therapy.

[53]  R. Epstein,et al.  The Values and Value of Patient-Centered Care , 2011, The Annals of Family Medicine.

[54]  A. Beck,et al.  Somatic symptom overlap in Beck Depression Inventory–II scores following myocardial infarction , 2010, British Journal of Psychiatry.

[55]  E. Halpern,et al.  Use of Remote Monitoring to Improve Outcomes in Patients with Heart Failure: A Pilot Trial , 2010, International journal of telemedicine and applications.

[56]  Mohan Karunanithi,et al.  A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP) , 2010, BMC cardiovascular disorders.

[57]  H. Rugo,et al.  Implementing decision and communication aids to facilitate patient-centered care in breast cancer: a case study. , 2009, Patient education and counseling.

[58]  A. Clark,et al.  Cardiac rehabilitation: into the future , 2009, Heart.

[59]  K. Davis,et al.  A 2020 vision of patient-centered primary care , 2005, Journal of General Internal Medicine.

[60]  M. Lauer,et al.  Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Su , 2005, Circulation.

[61]  Vassilis Koutkias,et al.  The Role of Wireless Technology in Home Care Delivery , 2001, MedInfo.

[62]  P. Bower,et al.  Patient-centredness: a conceptual framework and review of the empirical literature. , 2000, Social science & medicine.

[63]  J. de Haes,et al.  Doctor-patient communication: a review of the literature. , 1995, Social science & medicine.

[64]  Christian Lovis,et al.  White Paper: Patient-centered Applications: Use of Information Technology to Promote Disease Management and Wellness. A White Paper by the AMIA Knowledge in Motion Working Group , 2008, J. Am. Medical Informatics Assoc..

[65]  Michael Weiner,et al.  The influence of information technology on patient-physician relationships , 2006, Journal of General Internal Medicine.