Home Medical Care Support for Patients With Left Ventricular Assist Device Using Social Networking Service

Continuous-flow left ventricular assist devices (CF-LVAD) are increasingly used to support for the patients with advanced heart failure as bridge to heart transplantation. However, various complications management is necessary for patients at home after discharge. For two patients needed treatment for driveline infection site, we started management using Social Networking Service (SNS), evaluate the pictures taken by patients themselves, sharing how to care of wound site with visiting nurses. Subsequently, multidisciplinary medical staff such as Certified Nurse, Clinical Engineer, Wound Ostomy and Continence Nurse and Collaborating hospital doctor participated, we have started comprehensive VAD management including not only wound management but also anticoagulant therapy and device management. On the screen used only by medical staff, we can share patient condition smoothly anywhere and discuss treatment strategies with all staff. When a patient's device failure or pump thrombus was suspected, we instructed the patient an emergency visit, exchanged controller and adjusted acute phase anticoagulant therapy in short-term hospitalization. Then patient continued drip infusion at home care and collaborating hospital, performed safe anticoagulant therapy by measuring INR themselves every other day and adjusting the medication using SNS. Discussion: By using SNS, we could share more medical information and provide appropriate support system, which led to support of patient self-monitoring and to maintain both safety and quality of life.