MEDLY
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A companion for heart care

Visit the official Medly website HERE.

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Need

Heart failure is a complex chronic condition that occurs when the heart is unable to pump enough blood to meet the bodys needs. It is the most rapidly rising cardiovascular disease in Canada, with more than 50,000 new diagnoses each year, and affects over one million Canadians[1,2]. With recurring exacerbations, heart failure is the single most common reason for hospital admission and readmissions in Canada[1]. Thus, it is a major driver of rising health care utilization, costing the health system approximately $482 million in 2013[3]. Due to advancements in the clinical management of heart failure, more Canadians are living with heart failure and other comorbid conditions, further adding to the burden of heart failure on the Canadian health system. With projected costs of heart failure-related hospitalization increasing to over $722 million by 2030, the need to curb the use of acute health services is more critical now than ever.

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Our Service

What is Medly?

The program consists of two key components:
i) The Medly System: The core technology components that support the active monitoring of patients.
 ii) The Medly Service: The key people, processes and tools required to operationalize the Medly System.

Medly System 

The Medly application

The smartphone app and peripheral devices (weight scale and blood pressure monitor) enable patients to measure and record their weight, blood pressure, heart rate, and symptoms.

The Medly algorithm

Automatically generates self-care feedback messages based on personalized thresholds and treatment plans (i.e. prescribed medications) set by a patient’s clinician at the time of program enrollment.

The Medly dashboard

The web-based Medly Dashboard enables clinicians to rapidly assess a patient’s health status and respond to patients who have alerted through the Medly app.

Medly Service 

The Medly Service includes the key human resources and adaptable processes to operationalize the system and deliver on the intended outcomes.

The Medly Program clinical roles have been defined to directly link patients to cardiology specialists while optimizing clinician time. The primary clinicial role is a frontline Medly coordinator (a registered nurse or nurse practitioner) who reviews and responds to alerts and serves as the first resource for patients’ clinical concerns or technical troubleshooting.

The Medly Coordinator triages and escalates clinical concerns to the Most Responsible Physician (MRP), typically a cardiologist, who provides higher-level clinical expertise as needed. Critical alerts are always escalated, and sent directly to the patient’s MRP. The Medly team at UHN provides higher-level technical and application support to patients and providers, as required.

The responsibilities of the key Medly program roles vary based on the three phases of the program life cycle: onboarding, ongoing and offboarding. Understanding that each site is unique – including the services rendered, clinical workflows, and patient populations – the Medly program roles are reviewed and customized on a clinic-by-clinic basis to fit the needs and goals of each site.

Healthcare Human Factors is leading the product and service design of Medly. We designed the entire process from the moment when the patient receives Medly from their doctor, sets up the app, brings it home for everyday use, to their next visit to the doctor. We held workshops with the clinic to ensure that the process aligns seamlessly with the existing clinical workflow. At every stage, we ensure that with Medly in hand, the patient will feel more empowered, in control, and happier.

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What’s Next

Our team has worked closely with Medly from the inception of the app, to its first randomized controlled trial, which demonstrated improvements in heart function and self-care, to its deployment today. The Medly app is now being operationalized at the heart failure clinic at University Health Network, one of the largest hospital networks in North America. There, Medly is being prescribed by the clinician to the patient to take home, as they would with any prescribed drugs. Moving forward, we will be working with other clinics and hospitals to implement Medly, and change the lives of those with multiple chronic conditions.

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1. Heart & Stroke Foundation, The Burden of Heart Failure. 2017.
2. Blais, C., et al., Assessing the burden of hospitalized and community-care heart failure in Canada. Canadian Journal of Cardiology, 2014. 30(3): p. 352-358.
3. Ross, H., et al., Treating the right patient at the right time: Access to heart failure care. Canadian Journal of Cardiology, 2006. 22(9): p. 749-754.

 

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