The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) Trial
Open accessAbstract
Objectives The primary objective was to determine if wireless remote monitoring with automatic clinician alerts reduces the time from a clinical event to a clinical decision in response to arrhythmias, cardiovascular (CV) disease progression, and device issues compared to patients receiving standard in-office care. A secondary objective was to compare the rates of CV health care utilization between patients in the remote and in-office arms. Background In addition to providing life-saving therapy, implantable cardioverter-defibrillators collect advanced diagnostics on the progression of the patient's heart disease. Device technology has progressed to allow wireless remote monitoring with automatic clinician alerts to replace some scheduled in-office visits. Methods The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) study was a multicenter, prospective, randomized evaluation involving 1,997 patients from 136 clinical sites who underwent insertion of an implantable cardioverter-defibrillator (including cardiac resynchronization therapy devices) and were followed up for 15 months. Health care utilization data included all CV-related hospitalizations, emergency department visits, and clinic office visits. Results The median time from clinical event to clinical decision per patient was reduced from 22 days in the in-office arm to 4.6 days in the remote arm (p < 0.001). The health care utilization data revealed a decrease in mean length of stay per CV hospitalization visit from 4.0 days in the in-office arm to 3.3 days in the remote arm (p = 0.002). Conclusions Wireless remote monitoring with automatic clinician alerts as compared with standard in-office follow-up significantly reduced the time to a clinical decision in response to clinical events and was associated with a significant reduction in mean length of CV hospital stay. (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision [CONNECT]; NCT00402246).
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Integration with EHR may come across several obstacles, including demand for budget and resources, handling sensitive information, and interoperability issues.
“Admittedly, integration with EHR may come across several obstacles, including demand for budget and resources, handling sensitive information, and interoperability issues [33,52,118].”
From Talk2Care: An LLM-based Voice Assistant for Communication between Healthcare Providers and Older Adults (2024) · cites this paper as [33]
The Study limitations section discusses delayed activation of home monitors and clinicians not resetting alerts, while Statistical analysis discusses estimated hospitalization costs. Neither addresses obstacles to EHR integration. Searches for EHR interoperability, sensitive information, and budget or resource demands found no passage supporting the claim. (LLM, conf=0.76)
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- Authors
- Crossley, G. H., Boyle, A., Vitense, H., Chang, Y., & Mead, R. H.
- Affiliations
- Saint Thomas Health (US)
- Aurora St. Luke's Medical Center (US)
- Medtronic (United States) (US)
- Sequoia Hospital (US)
- Corresponding author
- Crossley, George H.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 57
- Issue
- 10
- Pages
- 1181-1189
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2183607324
- Cited by
- 526
- References
- 9
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 28 · 2023: 27 · 2022: 31 · 2021: 39 · 2020: 34 · 2019: 26 · 2018: 23 · 2017: 43 · 2016: 31 · 2015: 43 · 2014: 44 · 2013: 61 · 2012: 45
- FWCI
- 37.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medtronic
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- implantable cardioverter-defibrillator, wireless remote monitoring, cardiac arrhythmias, cardiovascular hospitalization, length of hospital stay, health care utilization, cardiac resynchronization therapy
- MeSH terms
- Aged, Arrhythmias, Cardiac, Cardiac Pacing, Artificial, Cardiovascular Diseases, Decision Making, Decision Support Techniques, Female, Humans, Length of Stay, Male, Middle Aged, Telemetry, Time Factors, Defibrillators, Implantable, Intention to Treat Analysis
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