Authors: (including presenting author): :
Wong SH (1), Leung CY (1), Hip LL(1), Seto NY (1), Li, SM (2), Wong CH (1)
Affiliation: :
(1) Department of Medicine, Tseung Kwan O Hospital (2) Physiotherapy Department, Tseung Kwan O Hospital
Keyword 1: :
Heart Failure
Keyword 2: :
Teleconsultation
Keyword 3: :
Remote Monitoring
Keyword 4: :
Ambulatory Care
Keyword 5: :
Multidisciplinary Model
Introduction: :
The escalating prevalence of heart failure (HF) places immense pressure on Hospital Authority (HA) services. Rapid and intensive titration of Guideline-Directed Medical Therapy (GDMT) was recommended to reduce HF hospitalization and improve patient outcome. However, conventional models require frequent physical visits, consuming significant clinical space and manpower. To address this, a hybrid service model was developed, integrating physical day-center assessments with teleconsultation and remote monitoring via the HA Go mobile application to optimize care delivery.
Objectives: :
To evaluate the efficacy and safety of a hybrid multidisciplinary HF program in improving clinical outcomes, functional capacity, and reducing hospital utilization through technology-assisted health management.
Methodology: :
A pilot study of 30 HF patients was conducted using a hybrid model: initial physical day-center assessment followed by remote teleconsultations. Patients performed self-health management by inputting blood pressure, heart rate, and body weight into the HA Go app. Clinicians utilized this data for GDMT titration in remote teleconsultations. Primary outcomes included changes in Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, 6-minute walk test (6MWT) distance, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and ejection fraction (EF). Hospital utilization was compared between equivalent six-month periods pre- and post- recruitment. Continuous variables were analyzed via paired t-tests and non-parametric data via Wilcoxon signed-rank tests.
Result & Outcome: :
Analysis of 30 patients demonstrated significant clinical improvements from January 2025 to January 2026. The median MLHFQ score decreased by 10 points (p< 0.001), while the mean 6MWT distance increased by 53.5 meters (p< 0.001). Biochemical markers showed a median NT-proBNP reduction of 485 pg/mL (p< 0.001). Structural recovery was evident with a mean absolute increase in EF of 10.5 percent (p< 0.001). Regarding service demand, total HF admissions dropped from 29 in the six months pre-recruitment to 1 admission during the 6-month post-recruitment period, representing a 96.5 percent reduction in hospitalization (p< 0.001). Four unplanned admissions were recorded due to GDMT adverse effects in two patients (6.7 percent). Flexible on-demand teleconsultation were available to address these preventable events.
