Dr. Matthew Barrett
Consultant Cardiologist, St Vincent’s and St Michael’s Hospitals
in Dun Laoghaire and the Bray Integrated Care Hub
Specialist blood tests taken in community healthcare settings are helping identify patients at risk of developing heart failure at the earliest opportunity.
Special blood tests taken in GP surgeries are highlighting heart failure (HF) sooner while virtual consultations between GPs and cardiac specialists are enabling better management of patients closer to home.
Sláintecare reducing hospitalisations
This initiative has been running in the Dun Laoghaire and Bray Integrated Care Hub area for four years and has already led to a reduced burden on emergency and outpatient departments, according to consultant cardiologist Dr Matthew Barrett.
He says that the initiative, which is part of the Sláintecare transformation of healthcare in Ireland, is seeing primary and community health services delivered through new models of care. “One part of that is prevention,” he adds. “In Dun Laoghaire, we are trying to identify patients at risk of developing heart failure.”
Routine tests to detect cardiac conditions
Earlier identification of HF allows quicker treatment and may avoid deterioration of the condition. Patients at increased risk may be treated with medication while an NTproBNP blood test can efficiently identify potential cardiac problems, including HF. It is offered to patients with diabetes or high blood pressure during routine check-ups. “We hope to identify these patients early and get them treated early so that they will avoid more severe HF,” says Barrett.
Patients at increased risk may be treated
with medication while an NTproBNP blood
test can efficiently identify potential
cardiac problems, including HF.
Virtual platform for specialist input
An important element is a virtual platform for GPs to discuss their patients with cardiac specialists to decide if they need further investigation, medication or access to clinical HF services. “It is a rapid pathway for GPs to identify problem patients and get a specialist opinion,” he adds. “Sláintecare mandates novel methods of facilitating specialist opinion and review — that is where our virtual model of care comes in.”
GPs are increasingly using the service instead of having to refer patients to the emergency department or outpatient clinics — with longer waiting times. “We have found a 90% drop in referrals to the ED or outpatient clinic, as a direct result,” reveals Barrett.
Benefits and challenges
Patients are getting prompter care with no travel. Hospitals benefit from reduced costs and pressure burden. Against a backdrop of rising HF, Barrett is involved with the PASSION-HF study, which is exploring ways to digitally automate routine engagement with HF patients. However, while the NTproBNP test and virtual platform are identifying potential HF patients, they must now navigate sufficient access to imaging, such as echocardiograms, to confirm the condition.