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Reimbursement practices for use of digital devices in atrial fibrillation and other arrhythmias: a European Heart Rhythm Association survey

Journal

EUROPACE
Volume 24, Issue 11, Pages 1834-1843

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/europace/euac142

Keywords

Atrial fibrillation; Digital medicine; Health technology assessment; Reimbursement; Screening; Wearables; mHealth; EHRA survey

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Digital devices, including wearables, are increasingly being used in cardiology for assessing cardiac rhythm and detecting arrhythmias. Healthcare professionals in Europe generally support reimbursement for the clinical use of digital devices but there is a lack of reimbursement for physicians' consultations related to digital devices in many countries. Some professionals express interest in using digital devices for arrhythmia detection.
Aims Since digital devices are increasingly used in cardiology for assessing cardiac rhythm and detecting arrhythmias, especially atrial fibrillation (AF), our aim was to evaluate the expectations and opinions of healthcare professionals in Europe on reimbursement policies for the use of digital devices (including wearables) in AF and other arrhythmias. Methods and results An anonymous survey was proposed through announcements on the European Heart Rhythm Association website, social media channels, and mail newsletter. Two hundred and seventeen healthcare professionals participated in the survey: 32.7%, reported regular use of digital devices, 45.2% reported that they sometimes use these tools, 18.6% that they do not use but would like to. Only a minority (3.5%) reported a lack of trust in digital devices. The survey highlighted a general propensity to provide medical consultation for suspected AF or other arrhythmias detected by a consumer-initiated use of digital devices, even if time constraints and reimbursement availability emerged as important elements. More than 85% of respondents agreed that reimbursement should be applied for clinical use of digital devices, also in different settings such as post-stroke, post-cardioversion, post-ablation, and in patients with palpitations or syncope. Finally, 73.6% of respondents confirmed a lack of reimbursement fees in their country for physicians' consultations (tracings interpretation) related to digital devices. Conclusions Digital devices, including wearables, are increasingly and widely used for assessing cardiac rhythm and detecting AF, but a definition of reimbursement policies for physicians' consultations is needed.

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