Telecardiology for patients with acute or chronic cardiac complaints: the 'SHL' experience in Israel and Germany.

Objective: To assess the impact of a telemedicine program in which electrocardiogram (EKG), body weight and/or blood pressure are measured at home and medically trained personnel judge the transmitted data and council the patients by telephone.

Method: We systematically studied the outcome and cost-effectiveness of the cardiac programs carried out by Shahal (SHL) during the past 19 years.

Result: Most patients (85%) with acute complaints resembling coronary artery disease, could be reassured, representing a savings of about 677.000 euro per 10,000 members/yr in Israël in 1989, and a marked reduction in patient delay to 44 min (median). In chronic heart failure a 66% reduction in hospitalisation days was observed, together with an improvement in quality of life. A large Healthcare Insurance Company in Germany (Taunus BKK) has calculated that it can save at least 5 million euro per year with the use of such services.

Conclusion: Disease management with concomitant telemedicine for coronary artery disease and chronic heart failure is safe and effective and has a huge potential for cost savings, improvements in quality of life and in prognosis of heart disease.