By the time patients are rushed to A&E and seen by internal medicine registrar Maximilian Weiss, it’s often almost too late. “In many cases, the cardiac insufficiency of admissions with acute decompensated heart failure is so advanced that they can no longer pump enough blood around their bodies to keep them alive. This causes oedema, accumulation of fluid in the lungs, shortness of breath and even unconsciousness. Ultimately, too many people die of an illness that actually presented symptoms some time ago,” he says. Sometimes, however, chronic heart failure can be largely asymptomatic for years. A further trigger, such as an infection, can then cause the condition to worsen and become acute, which often ends in an emergency admission to hospital – or worse. “Heart failure is now the most prevalent single diagnosis for inpatients and remains one of the most common causes of death in Germany, even though the number of fatalities has fallen thanks to better treatment options,” reveals Weiss. This is exactly where Actimi comes in. “If patients were monitored professionally, they could be treated in time to prevent decompensation and a stay in hospital. We could then cut both mortality rates and costs,” he continues.

“Telemonitoring is already common practice in the USA”

 To put his idea into practice, the young medic developed a real-time telemonitoring platform for patients with chronic diseases such as heart failure. In 2021, Actimi GmbH was founded in Stuttgart by Weiss (CEO), Julian Charisius (CMO) and Dietrich Charisius. The start-up combines conventional medical technology with an innovative SaaS (Software as a Service) platform. In other words, the software and IT infrastructure are operated by an external provider and used by the customer in the form of a service. Actimi now has 15 employees developing the infrastructure so that patients can monitor their condition in the comfort of their own homes using a smartphone app and devices that measure their blood pressure, blood oxygen, ECG, pulse and weight. The company is collaborating with a number of medically certified hardware providers for this purpose. “We regard it as vital for the medical devices to be highly accurate and easy to link to the Actimi telemonitoring app,” explains Weiss. Naturally, the app uses the latest FHIR (Fast Healthcare Interoperability Resources) standard, which is ideal for data exchange between software systems in the healthcare sector and, most importantly of all, the secure transfer of sensitive data.
 
The Federal Joint Committee (G-BA), the highest decision-making body for the joint self-regulation of healthcare organisations in Germany, has now incorporated heart failure telemonitoring into the statutory health insurance benefits catalogue and established rules for the associated billing. The corresponding cost items for services and a fixed cost were introduced on 1 January 2022 – a step that was long overdue according to Weiss. “Telemonitoring is already common practice in the USA. The necessary telemonitoring centres – which we call TMZs for short – now need to be set up here quickly to pave the way for a successful market launch,” he says. The new offering should not increase the workload of doctors in general practice. “No GP can be expected to monitor patients’ data 24/7. There will be specialised TMZs for that,” emphasises Weiss. Although it is envisaged that a patient’s doctor will be alerted if the readings worsen, a team of medics at a TMZ will provide additional round-the-clock support. “The web-based dashboard displays an overview of critical patients and their health status. If readings lie outside the defined limits, an alarm is automatically triggered,” explains Weiss. Selected family members can also be notified.