Getting ahead of heart failure, 1 alert at a time
The remote monitoring pathway keeping people with heart failure out of hospital
Backing the healthtech that changes lives
A groundbreaking approach to monitoring heart failure patients remotely has reduced unnecessary hospital admissions by 58%, improving patient experience and saving the NHS thousands of pounds.
What started as a research study in 1 hospital, before growing to a clinical trial across 3 hospitals, is now national guidance recommended by NICE.
"1 in 4 people will develop heart failure during their lifetime, so having robust systems to detect problems and prevent avoidable hospital admissions is essential.
This technology has radically changed how we monitor and manage patients with heart failure. By using remote monitoring data from pacemakers and defibrillators, we can now intervene early and deliver care precisely when patients need it, based on their clinical health data."
Janet, an 80 year old who has heart failure, feels reassured knowing that her device is constantly monitoring her heart.
"I now feel confident that I can visit my family in Ireland and still be well, as I know my condition is constantly being monitored by my doctors.”
Context
The issues faced
NICE recommends people living with heart failure should be monitored and assessed by their clinician at regular intervals, ideally every 6 months, and are advised to contact their medical team, or seek help, if their symptoms worsen.
By then, it is often too late. Many patients do not recognise the early warning signs, or by the time they do, their condition has deteriorated to the point where emergency hospital admission is unavoidable. This can mean patients spending longer in hospital with poorer outcomes.
Implementation
A smarter way to monitor heart health
Many heart failure patients have small devices implanted in their chests, such as specialised pacemakers and defibrillators, that constantly monitor their heart's activity as well as other health data.
These devices can detect early, subtle changes in the body that signal deterioration, such as rising fluid levels in the chest, heart rhythm irregularities, or reduced physical activity. Most importantly, the device can spot these warning signs up to 30 days before a patient would typically notice worsening symptoms or need to be admitted to hospital.
Building on this capability, specialists at Manchester University NHS Foundation Trust developed TriageHF Plus, a clinical pathway designed to translate early warning signals, detected by implanted devices, into clinical action. Rather than letting alerts remain unnoticed or acted upon too late, TriageHF Plus ensures that patients identified as high-risk receive prompt, specialist review and timely treatment.
How TriageHF Plus works:
- The system automatically flags patients identified as high-risk and alerts the specialist heart failure team.
- A specialist nurse then phones the patient to carry out a thorough assessment over the phone.
- Based on this conversation, they can adjust medications, provide advice, or arrange appropriate care. Early interventions like these often prevent the need for hospital admission altogether.
- Every patient is then followed up 30 days later with a phone call and assessment to ensure the intervention has been effective and symptoms remain stable.
Results
Real world data used to create national guidance
Implementing the TriageHF Plus pathway achieved a 58% reduction in hospital admissions
Patients are staying healthier at home, avoiding the stress and disruption of emergency hospital visits
A cost/benefit analysis also found the pathway delivers a net benefit of £4,158 per patient over their lifetime
Data from the trial in Manchester was used by NICE when producing its guidance on algorithm-based remote monitoring in people with cardiac implantable electronic devices. In 2024, NICE recommended TriageHF as an option for algorithm-based remote monitoring in people who have heart failure. The guideline included elements of the pathway developed in Manchester, recommending that the monitoring should be part of a specialist multidisciplinary heart failure service with alerts reviewed and acted on by specialist healthcare professionals.
“The 2024 NICE healthtech guidance has been transformational for patients across the UK, allowing thousands of patients to benefit from being monitored remotely and have their condition safely managed from their own homes. In a nutshell, identifying sick patients has gone from days and weeks to minutes.”
Lessons learned
Delivering personalised care at home
The success of TriageHF Plus demonstrates how technology can be harnessed to deliver better, more personalised care while reducing pressure on NHS services. Following NICE’s approval it has become a model for proactive heart failure care, potentially benefitting thousands of lives. By utilising existing technology more intelligently, we can catch problems before they become emergencies, treat patients at the right time, at home with fewer disruptions and improved long-term outcomes.
NICE has published healthtech guidance (HTG730) to support healthcare teams in adopting remote monitoring, with resources to help put it into practice.
“If the device triggers [any unusual data recordings] I get a phone call from a nurse, who asks me how I am. It is quite reassuring being monitored and if anything goes wrong, there’s someone at the other end of the device to put things right.
Discover what support looks like
The TriageHF Plus story shows what is possible when innovation, clinical commitment and national guidance come together. Whether you’re an NHS decision maker or a healthtech developer, NICE guidance can help you take the next step.
- View support for NHS commissioning of healthtech
- View support for healthtech developers seeking to scale use of healthtech across the NHS.
Built with Shorthand