Abstract 4147366: At-Home Management of Patients with Heart Failure Demonstrates Few Emergency Department Transfers and High Patient Satisfaction

Background and Objective: Mobile Integrated Health (MIH) interventions enable community paramedics to perform structured assessments, physical exams, and medication reconciliation, provide disease education, review follow-up instructions, and adjust medications or administer intravenous diuretics under the direction of the telehealth physician. MIH has been shown in other studies to reduce emergency department (ED) transfers and healthcare costs while maintaining high patient satisfaction. We aimed to assess ED transfer rates and satisfaction in our population of largely medically underserved patients living with heart failure (HF) managed at home by MIH. Methods: Patients at a large, urban, academic medical center were enrolled in MIH via clinician referral as needed. After receiving an MIH visit, patients were invited to complete anonymous satisfaction surveys via REDCap. Paramedics documented whether an MIH home visit resulted in an ED transfer. Descriptive statistics were performed to evaluate the survey response distribution percentage and calculate ED transfer rates. Results: Between January 2021 and March 2024, 2,678 MIH visits were conducted for heart failure patients in NYC, with some patients receiving multiple visits. Among these, 239 patients completed at least one survey; only the first was considered for analysis. The average age of respondents was 74.01 (SD 14.8). Patient satisfaction was high: over 90% of participants expressed satisfaction across domains of ease of technology use, self-management and preference for receiving care at home. The net promoter score (patients recommending MIH to others) was 9.56 out of 10 (SD 1.27). Only 67 visits (2.5%) resulted in immediate ED transport during an MIH visit. Conclusions: High patient satisfaction with MIH care management at home and low rate of immediate transfers to ED indicate effective at-home care. These findings support MIH as a viable model for improving healthcare delivery and patient outcomes in HF management.