A pioneering study, led by the Bellvitge University Hospital, the Bellvitge Biomedical Research Institute (IDIBELL) and the Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), has shown that telemedicine tools can transform the approach to heart failure, one of the most prevalent chronic diseases with the greatest impact on the health system. The results of the HERMeS (Heart failure Events reduction with Remote Monitoring and eHealth Support) trial, published in the prestigious journal The Lancet Digital Health, confirm that the combination of telemonitoring and teleintervention reduces episodes of decompensation by 70% and cardiovascular mortality by 54% in people with chronic heart failure.
The HERMeS trial, carried out between 2018 and 2022, included 506 patients hospitalised for decompensation in ten centres in Spain (Bellvitge Hospital, Valencia Clinic, Central de Asturias, Puerta de Hierro, Manises, Virgen de la Victoria, Arnau de Vilanova, Delta de Llobregat Primary Care, Viladecans and Moisès Broggi). The patients were divided into two groups: one received conventional treatment and the other used a mobile platform for daily telemonitoring and videoconferencing with medical teams.
The results are conclusive: in the group that used telemedicine tools, the risk of new cardiovascular events, hospitalizations, and readmissions was reduced from 41% (conventional group) to 17% (mHealth group).
“These data reinforce the need to incorporate telemedicine technologies into clinical guidelines for the treatment of heart failure, especially in highly vulnerable patients. It is a safe, scalable model capable of improving patients’ quality of life, while alleviating the burden on the healthcare system,” says Dr. Sergi Yun Viladomat, an expert in eHealth, member of the Multidisciplinary Community Heart Failure Unit (UMICO) and the Internal Medicine Service of the Bellvitge Hospital, and researcher in the Bio-Heart group of IDIBELL and CIBERCV.
From research to real application: the eOSS project
The HERMeS study has been key to promoting the eOSS (eHealth Based Operative Support System) project, developed by the Community Heart Failure Unit of the Bellvitge Hospital, with the collaboration of the Delta Primary and Community Care Management (GAPiC).
Within the framework of this project, a mobile application has been created that allows users to send biometric data, such as weight or blood pressure, daily from home and answer a short questionnaire about their state of health. It is a tool accessible to all people, regardless of their technological level or socioeconomic situation. The data is processed in real time thanks to the integration with the SAP clinical system, which allows immediate action in the event of an alert and prevents serious complications.
“It is a paradigm shift in health care: we have gone from reaction to proactivity, detecting decompensations before they worsen,” says Dr. Cristina Enjuanes, coordinator of the Community Heart Failure Unit and researcher in the Bio-Heart group of IDIBELL and CIBERCV.
The development of this application, led by the Information Systems Directorate of the Bellvitge-Viladecans Hospital Management and the areas of Southern Metropolitan Primary Care and Penedès of the ICS, was completed in just six months. It is already being used with patients admitted to the Cardiology Department of the Bellvitge Hospital and the EAP Sant Josep (GAPiC Delta), with prospects of being extended to other hospitals, primary care teams (PAD) and territories of the Institut Català de la Salut.
Innovation and sustainability for the future
The eOSS project also opens the door to the development of new predictive models based on artificial intelligence, which will allow treatments to be adjusted in a personalized way and promote more equitable and sustainable care. This initiative has been possible thanks to funding from the SISCAT Transformative Projects program and the company Novartis.
“Heart failure is one of the great challenges of the Catalan health system, with an incidence that affects more than 2% of the population. The integration of telemedicine will improve the quality of life of patients, reduce hospitalisations and relieve pressure on the health system“, concludes Dr Josep Comin-Colet, director of the Heart Diseases Area, director of Innovation, Research and Universities of the Bellvitge-Viladecans Hospital Management, and director of the Bio-Heart group of IDIBELL and CIBERCV.
About IDIBELL
The Bellvitge Biomedical Research Institute (IDIBELL) is a research center established in 2004 specialized in cancer, neuroscience, translational medicine, and regenerative medicine. It counts on a team of more than 1.500 professionals who, from 73 research groups, publish more than 1.400 scientific articles per year. IDIBELL is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona, and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).
About Bellvitge University Hospital (HUB)
Bellvitge Hospital is a public, university, research and innovative hospital, which celebrated its 50th anniversary in 2022. With 5,200 expert and committed professionals, it is the reference hospital for the citizens of L’Hospitalet and El Prat de Llobregat, and a centre of maximum complexity for two million people in southern Catalonia. It is the centre that performs the most complex surgery in Catalonia, especially oncological, as well as the highest number of kidney and heart transplants in adults. It integrates the patient experience as the axis of its projects and promotes networking with primary care and other hospitals in the area. Oriented towards personalised medicine, it has the best genetic diagnosis and imaging tools for cancer and rare diseases, and has the new High Diagnostic Precision Centre, which houses the first PET/MRI of the state healthcare network. It annually registers about 20,000 major surgery interventions, 37,000 discharges, 485,000 outpatient visits and nearly 100,000 diagnostic tests.
About the CIBER
The Center for Biomedical Research Network (CIBER) is a public consortium attached to the Carlos III Health Institute (Ministry of Science, Innovation and Universities). Its objective is to promote research of excellence in biomedicine and health sciences carried out in the National Health System and the Science and Technology System. The CIBER has some 6,000 researchers – between attached and contracted – distributed in 508 research groups belonging to more than 104 consortium institutions. Its scientific programme is organised into 13 thematic areas, one of which is Cardiovascular Diseases (CIBERCV).