Abstract

Background: Remote patient monitoring (RPM) for chronic heart failure (CHF) management has demonstrated clinical and economic benefits. However, data on its organisational impact remain limited, particularly in the French healthcare context following the integration of RPM into standard care pathways. The objective of this study was to describe the organisational impact of RPM for CHF management from the perspective of healthcare professionals across diverse practice settings in France. Methods: A cross-sectional survey was conducted among 28 French cardiology departments and community practices (14 CHG, 9 CHU, 4 community practices, 1 private clinic) actively using RPM for CHF management. The questionnaire assessed organisational changes across five domains: care process modifications, human resources allocation, professional training and task delegation, coordination with community-based physicians, and perceived impact on patient quality of life and working conditions. Results: Nearly all structures (96.4%) had established a dedicated RPM team (mean size: 4.8 ± 2.3 professionals). A reduction in time between cardiac decompensation and medical care was reported by 96.4% of respondents. Three-quarters (75.0%) had implemented specific consultations for emergency alerts, and 57.1% had established direct admission protocols bypassing emergency departments. Task delegation was widespread (89.3%), primarily involving alert monitoring (100%), patient inclusion (92.0%), and patient contact (84.0%). However, only 53.6% of professionals had received specific training. The perceived impact on patient quality of life was unanimously positive (64.3% very positive, 35.7% positive). Working conditions were perceived as stable by 64.3% and improved by 32.1%. The main advantages cited were reduction in hospitalisations (89.3%) and improved patient communication (85.7%). The primary area for improvement was interprofessional coordination (53.6%). Conclusions: RPM implementation has driven substantial organisational restructuring across French cardiology departments and community practices. While dedicated teams and task delegation are now standard, challenges remain in professional training, coordination with community physicians, and dedicated time allocation. These findings provide an updated organisational assessment that complements prior clinical and economic evaluations.

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