# Continuous Wearable Monitoring Analytics to Improve Outcomes in Heart Failure - LINK-HF2 multicenter implementation study

> **NIH VA I01** · VA SALT LAKE CITY HEALTHCARE SYSTEM · 2020 · —

## Abstract

Background Heart failure (HF) represents a major health burden, with 80% of the HF health care costs
attributable to hospitalizations. Reducing HF readmissions is a major VA strategic goal. Our pilot study
demonstrated that multivariate physiological telemetry using a small wearable sensor has a high
compliance rate and provides accurate early detection of impending readmission for HF exacerbation.
We now propose to implement non-invasive remote monitoring at 5 VA medical centers.
Significance/Impact Despite treatment advances, hospitalizations for HF exacerbation remain
prevalent and costly. Accurate and timely detection of incipient HF exacerbation may be one path to
reducing HF readmissions.
Innovation The study will develop an implementation strategy for noninvasive remote monitoring with
predictive analytics and an algorithmic treatment response to clinical alerts coming from the analytical
platform. The result will be a reliable link between the clinical alert and an intervention that can affect
the clinical outcome of the patient. Algorithmic response to the device alert will be a subject of ongoing
validation and update as part of the learning health-care system concept. This will allow for integration
with the electronic health record, optimization and standardization of the response process and
decrease alert fatigue. Furthermore, we will evaluate patient and provider attitudes toward using remote
monitoring to guide HF therapy, as well as the impact of this approach on key clinical outcomes.
Specific Aims Aim 1. Implement remote monitoring into the clinical workflow of HF care.
Aim 1a. Design implementation strategies for non-invasive remote monitoring and algorithmic
response to clinical alerts generated by the predictive analytics platform.
Aim 1b. Evaluate implementation outcomes, including clinician and patient perceptions and adoption
of the use of ambulatory remote monitoring data.
Aim 2. Conduct a feasibility study of non-invasive remote monitoring in chronic HF.
Aim 2a. Define key characteristics that will inform design of a pivotal trial of non-invasive remote
monitoring aimed at reducing rehospitalization and improving quality of life in HF.
Aim 2b. Identify costs associated with implementation and non-invasive remote monitoring in HF.
Methodology We will design implementation processes using the i-PARiHS framework and three
implementation phases: 1) implementation intervention planning; 2) formative evaluation of pilot
implementation at 2 vanguard sites; and 3) Implementation fidelity monitoring. We will enroll 240
patients hospitalized for HF exacerbation at 5 participating VA centers. All study subjects will receive
the monitoring kit, which will be used for 90 days after discharge. Subjects will be randomized 1:1 to
an intervention arm, where clinicians will be notified of clinical alerts and will follow response algorithm
to modify HF treatment or recommend urgent clinic visit/emergency room visit, and to the control arm...

## Key facts

- **NIH application ID:** 10064948
- **Project number:** 1I01HX002922-01A2
- **Recipient organization:** VA SALT LAKE CITY HEALTHCARE SYSTEM
- **Principal Investigator:** Josef Stehlik
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10064948

## Citation

> US National Institutes of Health, RePORTER application 10064948, Continuous Wearable Monitoring Analytics to Improve Outcomes in Heart Failure - LINK-HF2 multicenter implementation study (1I01HX002922-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10064948. Licensed CC0.

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