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Work Smart, Not Hard: Scheduling Remote Transmissions

Work Smart, Not Hard: Scheduling Remote Transmissions

Cardiac Device Remote Monitoring Scheduling

“Setting correct intervals, whether manual or automatic scheduling, in Boston Scientific, Medtronic Carelink, and St. Jude/Merlin/Abbott patient profiles can serve as a resource when determining the best dates for upcoming office visit device checks.”

by Amy Harris, PrepMD RMS Lead Patient Outreach Specialist

Auto-schedules, set to the correct intervals, reduce the risk of scheduling oversight, as well as billing inconsistencies for patients keeping track of their medical balances. 

In addition to billing predictability for patients, scheduling pacemaker and defibrillator remote transmissions at the standard minimum interval of 91 days increases the likelihood of obtaining four remotes per year, per patient.    

Setting intervals to 98 days to allot more time to initiate the billing process results in fewer transmissions each year per patient, and reduces clinic revenue for remote monitoring.

The same result is true for remote schedules which are skipped or “pushed out” for office visit interrogations. Setting correct intervals, whether manual or automatic scheduling, in Boston Scientific, Medtronic Carelink, and St. Jude/Merlin/Abbott patient profiles can serve as a resource when determining the best dates for upcoming office visit device checks. 

Scheduling loop recorder/ICM transmissions each 31 days is the standard minimum, however, intervals of 35 days ensure transmissions arrive on weekdays (for clinics wishing to avoid weekend billing).  

Medtronic and Boston Scientific require a few
unique steps during the scheduling process

Patient accounts in Carelink with bedside monitors and implanted devices compatible with Smart Scheduling are represented by a symbol . This icon indicates the implanted device is capable of automatic, cycling scheduled transmissions.

The absence of this icon is noted for devices which require patient-initiated manual transmissions, such as with the Advisa, Adapta, Micra, Sensia, Revo, and Versa. 

For Medtronic Carelink, there are different scheduling options and requirements  

Single 

  • Located under the “Schedule” tab, these one-time schedules are used primarily for pacemakers or defibrillators programmed only to manually transmit. Patients are informed of future transmission date(s), and send data independently. 
  • Single, or one-time scheduling may also be utilized for any pacemaker or defibrillator which is capable of Smart Scheduling, but is opted out of automatically recurring transmissions (e.g., Monitoring physician preference, or report data/billing concerns). 
  • In some cases, both Single and Smart schedules can be used, however, it is more efficient to select one option to avoid scheduling overlap or error. 

Series

  • Located under the “Schedule” tab, compatible pacemakers or defibrillators can utilize a Series, or auto-cycled schedule. This method ensures home monitor transmissions are being sent on time, every time, and provides notification when they have failed.
  • The earliest possible transmission date is provided, and custom intervals can be selected.     
  • If a bedside monitor experiences connectivity issues, a Series set to transmit on an interval will automatically place that patient within the “Missed Transmissions”, “No Schedules”, and/or “Disconnected Monitors” category for your review. 

Summary (Loop Recorders)

  • Located under the “Overview” tab, “Summary Reports” are clinical reports generated for LINQ devices. These can be set to a one-time or recurring schedule. 
  • LINQ schedules should not be set under the “Schedule” tab. Whether one-time, or recurring transmissions, a Summary Report cannot be generated unless set up utilizing the tools provided under “Overview”  
  • Note: LINQ schedules created under “Overview”, do not populate the date of the next transmission under the dashboard column labeled, “Next Scheduled Send” (for defibrillators and pacemakers). It instead will read, “Not scheduled”. 

Boston Scientific provides a link at the top right of each dashboard to toggle between “Clarity” for loop recorders, and “NXT” for defibrillator and pacemaker device transmissions.     

Scheduling in NXT 

For pacemakers or defibrillators, within each patient profile is an option to “Edit/View Schedule and Alert Configuration”. 

For Latitude NXT, there are different scheduling options and requirements  

  • Schedules can be set as a clinic default (managed in clinic settings)
  • Or customized with automatically recurring intervals 
  • Select the next scheduled remote follow up date in blue to view the calendar, and ensure the weekday is matched with the “Day of the Week” dropdown. 
  • NXT provides the option to change or set remote transmission schedules either directly from the dashboard, or within “Schedule and Alert Configuration”. 

If electing to set or edit the next transmision date on the dashboard, the date must fall on the same weekday specified under “Schedule and Alert Configuration”, or else the transmission may be “missed” as a result of the date contradiction.

As a method of efficiency, all schedule editing should be carried out under “Schedule and Alert Configuration”

Scheduling in Clarity

Access Clarity using the top right toggle link 

  • Select patient to view profile. 
  • The next scheduled date can be selected from the calendar without an associated weekday dropdown.  

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