By Jessica Lovell
It’s not a solution to satisfy all pacemaker patients, but a fraction of Guelph patients are being offered an alternative to making the trek to Kitchener to have their devices monitored.
In the wake of the closure of Guelph’s pacemaker clinic and integration of services at St. Mary’s General Hospital in Kitchener, the hospital announced Friday that it plans to offer remote monitoring to pacemaker patients in Guelph.
“They have snagged the first pilot site in Ontario for this equipment right here in Guelph,” said local MPP Liz Sandals. When the decision to close the local clinic was first made back in the spring, the remote monitoring technology had not yet been approved by Health Canada, she said.The technology that has now been approved, though, applies only to one particular type of pacemakers, called Medtronic pacemakers.
It’s patients with those pacemakers who will be given the chance to take part in the pilot, which will “explore the feasibility of large-scale remote monitoring,” said St. Mary’s president Don Shilton at the announcement at Evergreen Seniors Centre.
Of the patients who were transferred from Guelph’s clinic to St. Mary’s, about 50 per cent have this type of pacemaker, but eventually “the goal is to extend this service to patients with other pacemakers,” he said.
To begin with, though, there are still many unknowns. Timing, locations for monitoring sites and exactly how many people will be part of the pilot have yet to be determined. Not all of the several hundred patients with Medtronic pacemakers will qualify.
“The first thing is whether they want to do it,” said Dr. Claus Rinne, a St. Mary’s cardiologist.
He also made a point of saying that remote monitoring “does not replace clinic visits; it reduces the frequency of them.”
The monitoring will continue to be a scheduled activity, where patients will have to go to an appointment at a local site that has not yet been determined.
A technician at that site will use equipment to check the patient’s pacemaker. That equipment will relay data to St. Mary’s, where clinic staff will be able to see that the pacemaker is operating as it should. If there are any concerns, the patient will be contacted and a clinic visit may be scheduled.
If patients are interested in being part of the pilot project, symptomatic issues will be examined before determining if they are eligible, said Rinne.
“A large percentage of people are going to be eligible,” he said, but he added that he won’t be surprised if some are not interested.
“Despite what’s been said, a lot of people really like to come to the clinic,” Rinne said.
Not all Guelph pacemaker clinic patients were from Guelph, but for many Guelph patients, transportation to Kitchener has been the greatest concern associated with the closure of the local clinic.
“As far as I’m concerned, we didn’t really need to close this facility,” said pacemaker patient Terry Diggle.
Diggle has a Medtronic pacemaker and expects to learn whether he is eligible for the pilot project at his next visit in December. He hopes to be able to take part.
“I just think it’s a good option. It’s a good alternative and it’s long overdue,” he said.
Diggle, and fellow pacemaker patients Jim Mahone and William Winegard, have been fighting the closure of the Guelph clinic since they first learned of it, and this fight continues.
“We just want to be monitored in Guelph,” said Winegard, who does not have a Medtronic pacemaker and so will not qualify for the pilot.
While remote monitoring may work for some who qualify, it is not the broad solution the patients want to see.
A satellite clinic – even one run out of a trailer – would be preferable to making patients, the majority of whom are seniors, travel to Kitchener, said Winegard.
“We do it for libraries. Why can’t we have a heart mobile?” he said. “There’s no reason why a small clinic run by St. Mary’s couldn’t be run here in Guelph.”
Winegard will be speaking on the issue at an open house on Oct. 18 at 3 p.m. at the University of Guelph’s Arboretum. The event is being put on by students in Mahone’s Community and Environmental Leadership class, who are taking on the issue as part of their course.
One barrier to operating a satellite clinic may be finding sufficient staff with the specialized skills required to operate it.
“This came about because pacing has become too specialized,” said Rennie, explaining that staffing issues were part of the reason behind the clinic integration.
“The level of expertise required from a cardiologist these days is a very high level,” said Shilton. “Those who do have the expertise are very few and far between.”
By Jessica Lovell