Using telemedicine to implant ICDs

Heidelberg Private Clinic’s first NayaMed Remote Tech Support experience with Dr. Med. M. Natour and personnel.

Dr. M. Natour, MD, FESC, EC is a specialist in internal medicine with a focus in Cardiology and also the director of Heidelberg Private Clinic (HPK).  This modern  medical institution utilizes its cardiac catheter laboratory and operating room to deliver medical device implantations, as well as ablation therapy, coronary angiography, balloon dilatation (PTCA) and stent implantations.  The outpatient clinic manages the complete diagnostics and therapies in the field of cardiology, such as echocardiography at rest, stress-echocardiography and transesophageal echocardiography (TEE), electrocardiograms (ECG), rest and stress-ECG and electrocardioversion.

In early April this year, during the Congress of German Society of Cardiology in Mannheim, Dr. Natour experienced the NayaMed Remote Technical Support (RTS) at our congress booth.  Excited about this new technology, he decided to use this telemedicine solution during a NayaMed ICD implant back at his private clinic in Heidelberg.

After the implant, we asked his opinion on not only our technology but also our service.  Here’s what he had to say:

NayaMed: Can you briefly describe the implant you did today: the patient indication and a general description of the procedure?

Dr. Natour: The implanted patient is 70 years old and a primary prevention patient. We implanted an ICD to prevent sudden cardiac death due to ventricular fibrillation because he is suffering from a very low ejection fraction.

We did it today and it was very good. It’s our first time doing an implant like this – with the RTS. I was very impressed as it went very easily. Thank you for your support…for being with us.

There’s nothing that I didn’t like. To be honest, it was very good! It was going as it should…it took something like 40 minutes, and to implant a dual-chamber ICD in 40 minutes is a good time. I like it!

NayaMed: For you as a user, did anything change for this implant compared to other ICD implants where a Technical Advisor was physically present in the procedure room? How confident did you feel knowing that you had a technical expert from Lausanne guiding the programmer user?

Dr. Natour: Let’s answer the second part of the question first: I did feel really confident having you in our operation room to support us because it’s the first time dealing with ICDs from NayaMed. So it’s a good feeling to know there’s an expert who may help us if there’s a need to have it. On the other hand, it was very impressing to work that way [remotely via the RTS]…and to communicate with someone from Lausanne and to know it is good for the future – it would be saving time and maybe also money to work this way because we don’t need to wait until someone comes from the company. We have support if we need it – so we can do it this way.

NayaMed: How easy was it for you and you staff to install the RTS system?

Dr. Natour: Once again, thank you for your support – for being here and helping with that – but I think it’s not a big deal to install it by ourselves. For the first time, it wasn’t clear what my staff should do, but actually if you look at the system and the device: connecting two cables in the right place is not a big deal – so I don’t think it will be a big problem in the future. Also, you are always available, so we  can always contact you.

NayaMed: How open do you think your staff is to gaining autonomy and knowledge in performing tasks initially performed by industry representatives, knowing that they can always be guided by a Technical Advisor in Lausanne?

Dr. Natour: My staff are very open-minded and supportive of us doing new technological things. But it’s always a challenge for them and the physicians’ team to work with new things. So knowing we have support in case we need it is also very good. It was a new experience also for all of us to work that way. As you saw the face of Mrs. Becker [the nurse who ran the Analyzer during the implant]: She was happy to use the RTS and she was happy to complete the tasks necessary for the implant!

NayaMed: Do you see advantages to a support solution in which a representative doesn’t have to be in the hospital?

Dr. Natour: We are in a lucky position when we don’t have to pay a lot of money when a representative is supporting us in the hospital. But I think there are clear advantages for some places and hospitals where they have to pay for the service. This will be a very good alternative to that – as long as it’s not complicated to work with it.  The service is very good, so I think it will be a step for the future.

NayaMed: Where do you see the industry heading as it relates to the growing support burden of device patients?

Dr. Natour: I think the industry and the device companies have to adapt their search to the situation with the patients because they are getting older, and they live longer – which is good but they have a lot of disease so you have to be aware of that disease and to go with the time and with the patient. To develop new devices and new possibilities to watch them and monitor them because if they get older they will not be able to visit our hospital, for example, and they will have to stay at home — so the device should be able to give me some information via telemetry. 

NayaMed: From them at home?

Dr. Natour: Yes, and, for example, not only the device data. The device should support me and provide me with information about their current situation: their weight, their blood pressure, maybe their BNP…all those things…these would really be a big help – both for patients and for doctors.

NayaMed: What is the single most important advantage you see with the RTS?

Dr. Natour: I think it’s a real advantage to work with new technology. I love to work with new technologies and to update my clinic. And this option [RTS] to work with is, for me, a kind of change – that one accepts to do the implant this way. Besides this, you save a representative from the industry. You save money. You save time waiting for them because they may be somewhere else and helping by implanting at another hospital. So we can start and do it by ourselves.

NayaMed: Would you feel confident in the future having the majority of implants through RTS?

Dr. Natour: Well, I think I was a bit not confident for the first implant. But the RTS procedure went very well, and I’m feeling good and I really feel confident. I don’t think there will be a problem to deal with that.

Alexandru Trif
NayaMed Product Manager

http://www.nayamed.com

---