Abstract
BACKGROUND: Readmissions after heart failure hospitalizations can be reduced with early outpatient visits, nurse-led management, and implantable sensors, but these require heavy staff involvement. PROJECT RATIONALE: We tested whether an asynchronous digital outreach program with regular texts/emails plus a sweepstakes rewards system could activate patients, improve adherence, and reduce 30-day all-cause readmissions. PROJECT SUMMARY: Enrollment included 375 patients (mean age: 76 years; 62% male; reduced ejection fraction: 61% or preserved ejection fraction: 39%). Overall, 58 patients were readmitted, indicating a rate of 15.5%, which is 35% lower than the national historical average of 24%. Among "highly engaged" patients, the readmission rate was only 7.7%, representing a dramatic 68% decrease. In contrast, "low to moderately engaged" patients had a readmission rate of 21.6%, suggesting that level of engagement was a driver of readmission. TAKE-HOME MESSAGE: We conclude that digital outreach and a rewards program can reduce 30-day all-cause readmissions after a heart failure hospitalization.