Key Takeaways
- Duke Health offers remote patient monitoring to identify patients who need physician care as they decompensate, supporting cardiologists in the community.
- Remote monitoring uses devices that are implantable, wearable, or fully external, such as scales and smartphones, to detect early signs of heart failure and improve medication compliance.
- Duke’s Heart Failure Remote Cardiac Monitoring helps to scale patient care to meet the growing burden of heart failure.
Duke Health physicians and researchers are developing new paths to provide remote patient care to allocate resources and scale care to patients with heart failure (HF) who need it most. “We have a societal problem: there are so many patients with HF, cardiologists can’t possibly care for them all,” says advanced HF specialist Marat Fudim, MD, MHS, director of Duke’s HF Remote Cardiac Monitoring and Duke Heart Center Clinical Research Unit.
Research has shown how devices — ranging from implantable cardiac devices, such as cardioverter-defibrillators (ICDs), to scales and smartphones — can be used to support patients with HF. “Remote patient care [RPC] allows us to scale care to address the population’s needs,” Fudim continues. With only a few staff members, Fudim’s remote group can manage thousands of patients who receive care at Duke or in their communities.
In clinical practice:
- CardioMEMS HF System (Abbott, Abbott Park, IL): sensor implanted in pulmonary artery
- ZOLL HF Management System (ZOLL Cardiac Diagnostics, Pittsburgh, PA): noninvasive, patch-based device monitoring pulmonary fluid levels
- Sensinel Cardiopulmonary Management system (Analog Devices, Wilmington, MA): noninvasive device worn for five minutes daily monitoring hemoynamic changes
- Bodyport Cardiac Scale (Bodyport, San Francisco): detects hemodynamic biomarkers to assess heart function and fluid status
- Existing ICDs
In research:
- Cordella HF System (Endotronix Inc., Naperville, IL): sensor implanted in pulmonary artery
- FIRE1 System (FIRE1, Dublin): sensor implanted in the inferior vena cava
Smartphones to support patients
A new study published in The Lancet in June 2026 found that remote care increased patients’ compliance with guideline-directed medical therapy (GDMT) for HF across all four pillars. Duke Health cardiologist Adam DeVore, MD, MHS, lead author of the VITAL-HF study, says this remote care can help support physicians and patients alike: “These findings demonstrate that digital, asynchronous care models can safely improve medical therapy for patients with heart failure above and beyond traditional clinic-based care.”
At six months, patients using a smartphone app for GDMT support showed greater improvements. Their mean HF Collaboratory medical therapy score, which measures GDMT compliance, increased from 5.2 to 7.2, versus an increase of 4.8 to 6.3 in the control group receiving usual care (p = 0.007). Additionally, compliance went up across all four pillars, with 43.9% of patients in the intervention group receiving all four at six months, up from 15.2% at baseline.
“If we can get people on the right doses and the right number of medicines sooner, they have the possibility of living longer and staying out of the hospital more,” DeVore says. “This valuable research helps us to adapt to care for patients at all stages of HF as a leading center.”
The study was funded by Innovaccer Inc. (San Francisco), which owns Story Health, the smartphone app used in the trial.
The future of remote care
Remote monitoring alone will not necessarily help patients with HF. “When we monitor patients, we could abdicate the responsibility to provide care,” Fudim says. “We shouldn’t just call patients when there’s a problem. We need to focus on offering patients solutions: providing personalized care and titrating medications — providing care and not just monitoring.”
Physicians cannot be replaced by remote monitoring teams. “Our monitoring work complements referring physicians’,” Fudim explains. “Patients receive the device from us, but our goal is that you continue caring for them. We provide additional support for increasingly busy cardiology or medicine practices.”
Fudim believes RPC is the future of care: “Remote monitoring helps us provide effective care for patients — improving quality of life and longevity — at scale.”