Telehealth for heart patients

Read how telemonitoring and innovative technologies facilitate and optimize high-quality treatment and care in rural region of Portugal.

5min

Manuel Meyer

Published on February 28, 2022

In a hospital in Évora, a rural region of Portugal, heart patients from far and wide are already experiencing the future of interventional cardiology. Telemonitoring and innovative technologies facilitate and optimize high-quality treatment and care – even in the sparsely populated remote areas of the Alentejo. Two patients share their stories of recovery.

At some point, the first symptoms set in. “I was always tired. My legs and hands hurt,” says Francisco Antonio Rosa, who is seated on the garden terrace of his family home in Lisbon. He didn’t know what was wrong. “I had always been healthy and full of energy,” says the 84-year-old.

Francisco Antonio Rosa explains why he chose the hospital in Évora:

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Despite his advanced age, Rosa was still managing his pastry shop (the well-known Pastelaria Dâmaso in the Avenida de Roma in Lisbon) every day from morning till night, up until six months ago. “The contact with my regular customers has always been very important to me,” he explains. But suddenly his health didn’t allow him to work anymore. Medical examinations revealed that Rosa had a heart valve defect. His cardiologist recommended that he seek treatment from Portugal’s renowned interventional cardiology specialist, Professor Lino Patrício, who worked at the Hospital de Santa Marta in Lisbon. That sounded perfect, as Portugal’s largest university hospital is right next to Rosa’s home. The problem was that Patrício was no longer working at the site.

Learn where high-end cardiovascular and telemedical care is available in rural Portugal:

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Interventional cardiology meets state-of-the-art telemedicine

He had moved to the Hospital do Espírito Santo de Évora (HESE), a hospital in the rural Alentejo. Here, in the country’s interior, around 150 kilometers from Lisbon, Patrício is working with Siemens Healthineers to develop one of the most modern and innovative interventional cardiology centers in the country. Thanks to its long-term partnership with Siemens Healthineers, the integrated cardiovascular center in Évora not only boasts telemedicine solutions and consulting services for process optimization, but also the latest imaging technologies. This meant that Patrício and his team could perform transcatheter aortic valve implantation (TAVI) on Rosa. The procedure involves implanting an aortic valve into the beating heart via a catheter and without general anesthesia. HESE has the only cath lab in the south of Portugal and outside of Lisbon that can use this minimally invasive technique in heart surgery.

Long-term partnership

This is a Value Partnership that emcompasses individually tailored services.

Learn how Francisco benefits from telehealth solutions as he receives medical care even while he’s in his own home:

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Good care from the start thanks to telemonitoring

This is an innovative technology that Rosa could trust. He says he felt that he was in good hands even before the intervention. Although Lisbon and Évora are relatively far apart, the telemonitoring system meant Rosa was in permanent contact with Patrício’s team even before he underwent surgery. Every morning for many weeks, he used the devices he had been loaned to record his weight, blood pressure, blood SpO2 levels, and heart rate. He then sent the data using a smartphone app to HESE, where three clinical staff members are assigned exclusively to evaluate patients’ vital signs.

Telemonitoring

Telehealth empowers physicians and patients to interact virtually with each other anytime and anywhere just in minutes.

Confidence and security

“To begin with I needed the help of my son, Nuno. But the devices and app are very easy and intuitive to use,” says Rosa. As a precaution, though, his wife Maria Lurdes was always with him when he took and sent the clinical measurements. Whenever there was a deterioration in some key parameters, he received a call from a telehealth coordinator or his physician from Évora. “That gave me confidence and security,” says Rosa. Remote monitoring of his health prior to the operation also made his everyday life easier. “Because that way I didn't have to constantly go to my cardiologist or even to the hospital in Évora to check my health status, which I would have been reluctant to do during the COVID-19 pandemic,” he says.

This way [with telehealth] I didn't have to constantly go to my cardiologist or even to the hospital in Évora to check my health status.
Francisco Antonio Rosa, Lisbon

On the morning after our interview, nurse Marisa Serrano prepared Rosa for surgery while Patrício and his team of physicians studied the latest images of his aorta and arteries in the neighboring room. Rosa was happy that the time had finally come: “I want to get my quality of life back, play with my three grandchildren, and finally be able to go for a walk again with my dog Max.”

Fast access to Franciscos´ health information helped speed up treatment planning:

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TAVI procedure reduced anxiety

For Constança Pires, this dream is already a reality. In mid-August, Patrício implanted a new valve in her heart using the TAVI procedure. “After a few days I was fit again and I have since been able to lead a relatively normal life,” says the 79-year-old from Evoramonte. She’s a little annoyed with herself that she waited almost five years. “It got to the point where I could hardly leave the house, I had so little strength.” Her garden with its olive and citrus trees lay untended. She and her husband Lúcio could no longer take care of it. Shopping and cooking were also difficult for her. For a long time Pires resisted a heart operation out of fear that her ribcage would have to be opened. However, when she had another dizzy spell in July and was told about the TAVI procedure and telemonitoring that was now available at HESE, she finally consented to the intervention.

TAVI procedure

With this method a biological prosthetic heart valve is implanted through a small access by catheter.

Constança Pires tells how she benefits from telehealth that has made her life safer and worth living again:

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Optimal care in a sparsely populated province

Pires’s granddaughter helped her to collect her data and send it via smartphone. The remote health monitoring before and after the intervention had several advantages for her: She didn’t have to visit the hospital regularly for preliminary and follow-up examinations during the COVID-19 pandemic, and it saved her a lot of time and money. Evoramonte, a small community of 500 people, is only 30 kilometers from Évora. Yet people living in the villages of the sparsely populated region are effectively isolated if they don’t have a car. The Alentejo region occupies a third of the area of Portugal, but just 700,000 people live here. That is 22 people per square kilometer. Intercity buses only run to Évora twice a day. “And a taxi for the return trip would have cost me €70 each time,” says Pires, who, as a former plantation worker, does not have a large pension. For her, telemedicine is a blessing – both in health and financial terms.

Product information

By Manuel Meyer

Manuel Meyer reports from Spain and Portugal for Ärzte Zeitung (a German newspaper for physicians and other medical professionals) and other media outlets. He is based in Madrid.

The statements by Siemens Healthineers customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.

The shooting/interview/fotoshooting took place under all necessary health and safety measures according to local Covid-19 regulations.