In one year alone, 4,330 admissions to hospitals in Greater Manchester were related to heart failure, with treatment costing the NHS more than £17 million. Heart failure means that the heart is unable to pump blood around the body properly, usually because it has become too weak or stiff, and requires treatment such as medication, a medical device, or surgery.

Identifying patients at risk of worsening heart problems earlier would help doctors to provide them with appropriate treatment sooner and prevent a problem from turning into a crisis, resulting in having to attend A&E for heart failure.

A team of clinicians, academics and industry in Greater Manchester, an area with particularly poor heart failure outcomes, have come together to study information captured in heart failure patients’ pacemakers and defibrillators. The aim was to spot signs of heart deterioration earlier, identify patients at risk, explore the effectiveness of heart devices to monitor problems, change the way care is delivered to respond to early alerts and ultimately, radically improve outcomes for all heart failure patients.

The team carried out the largest evaluation of remote monitoring pathways for heart failure in a cohort of patients at Manchester Royal Infirmary, to see how successful it would be as a screening tool for identifying those with a worsening heart condition.

They looked at how they could transform the care pathway, a clinical process for managing patients with similar conditions, in an automated, high-tech way, and link up the health data captured in heart devices with other health datasets across the NHS and care system. By making better use of all the patient data available, it can help to improve care pathways, and, in turn, improve the effectiveness and accuracy of frontline care of patients.

The pathway was proved to be an excellent way of remote monitoring patients with heart failure. Creating a personalised and risk-based approach to screening has provided accurate diagnosis of heart issues, as well as a wider range of acute medical issues amongst these patients. The researchers have also shown that they are intervening on the alerts raised in a way which they anticipate is changing the course of disease progression.

The team has also developed a machine learning algorithm to identify other patients who may have heart failure problems in the future and who would be suitable for a heart monitoring device to keep track of their condition.

They have established that remote monitoring of heart failure, using devices that are already implanted, can change traditional models of healthcare to be fit for the future, with patients being treated based on their clinical need, at a time when they are unwell.

This one-year project, supported by HDR-UK and the Medical Research Council and funded by the UK Research and Innovation’s Industrial Strategy Challenge Fund, has helped to align health data of heart failure patients, enabled clinicians to better identify patients at risk of heart problems, and get patients the treatment they need sooner.

The team is on the road to transforming heart failure pathways in Greater Manchester, with plans to roll this out across other regions and across other health conditions.

Project team: Health Innovation Manchester, Manchester University NHS Foundation Trust, Medtronic, University of Manchester, North West EHealth