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Writer's pictureThomas Castles

Patients Are Recovering From Cardiac Surgery at Home — and Taking Their Care Teams with Them



Marsha Pruitt was weighing in for a routine health checkup when her nurse eyed her with concern.


“You’re holding your chest,” the nurse said. “Are you OK?”


Not one to cause a fuss, Pruitt brushed off the worry.


“Sometimes I have this little flutter in my chest,” she said. “But it goes away. It’s no big deal.”


The nurse wasn’t so sure. The routine wellness visit was now a cardiac appointment. She called in a specialist, and what they found was a big deal: extensive blockages that even stents couldn’t fix.


Pruitt needed open heart surgery. Her care team was quick to answer her questions leading up to the operation, but when she returned home to recover afterward, new worries surfaced.


“You don’t know what’s normal,” she explained. “You never had this kind of stuff done.”


At many hospitals, patient support would have ended upon discharge. Pruitt would be left to manage her recovery alone. But her story is different. Following surgery, she remained connected to her care team through virtual visits and remote patient monitoring. For months, her nurse navigator was virtually at her side to alleviate her worries, track her progress, and ease her journey back to health.


“The value of the program, it’s priceless. It’s truly priceless,” Marsha Pruitt said.

Overcoming Common Cardiac Care Challenges

The program, part of Atrium Health’s Perfect Care initiative, leverages solutions like Carium — an end-to-end platform that functions as a complete ecosystem for delivering virtual care — to expand the continuum of care and provide ongoing support outside hospital walls. It engages patients who undergo cardiac surgery and their families from pre-surgery education and optimization through discharge and beyond. From their homes, patients get professional insights into their recovery via video check-ins and messaging with their care team. Care teams get real-time data from biosensors that they use to inform ongoing clinical decision-making.


“It’s more than just devices connected to your body,” said Dr. John Frederick, Atrium Health Sanger Heart & Vascular Institute chief of cardiovascular surgery. “It’s a nurse navigator assigned to your case. It’s a weekly virtual visit to check in on you. It’s the ability to text your provider 24/7 with questions.”


The initiative rectifies challenges that have worsened outcomes and strained health systems in the past. Patients prefer to be home, but recovering from invasive surgery without expert guidance can be scary and dangerous. Providers need up-to-date, reliable data to inform post-surgery decision-making, but collecting that data and turning it into insights can be a chore.





A New Patient Experience

As Pruitt’s experience shows, insights are easier to unearth these days. Her Perfect Care journey began with a pre-surgery meeting with nurse navigator Kennedy McClain, who Pruitt described as “my lifeline.” McClain explained the procedure and introduced Pruitt to the virtual care application and remote monitoring devices she’d use afterward.


Pruitt’s only other operation was an appendectomy at age six. It required a month-long hospital stay, so she assumed she’d be hospitalized for a while after her open heart surgery. This time, Pruitt was discharged in less than a week. “Are you sure?” she asked her surgeon, amazed she was walking a day after the procedure.


Pruitt was eager to go home, describing herself as “not a hospital kind of girl.” But she also worried about leaving constant observation for life at home with only her husband to take care of her. Heart surgery was complex. Wouldn’t recovery be complex, too?


McClain made it simple. She bridged Pruitt’s transition from hospital to home, and the two fell into an easy rhythm, texting and talking on the phone between scheduled virtual visits.


Was she supposed to refill her prescription? What should her incision look like as it heals? When could she start going on walks with her husband again?


Pruitt never hesitated to ask. In total, she called her care team six times. She even sent McClain a picture of her incision through the application. It was comforting to know that McClain understood her background and was monitoring her recovery as it unfolded.


“It was just a huge relief to have her on the other end of the line,” Pruitt said.

The close personal relationship was a far cry from Pruitt’s experience calling a maternity ward with questions after giving birth years ago. Back then, the clinicians she dialed were well-meaning, but they gave generic responses because they knew nothing about her background or health goals, let alone her real-time vital signs.



Care teams at Atrium Health agree that ongoing communication and a steady flow of data transforms patient recovery. Regular connection means providers and patients can get to know each other — their families, hobbies, aspirations, and more. It humanizes the healthcare experience for everyone. Providers don’t feel like nameless faces, and patients know they’re not just another number on a call list.


“This has really given me an opportunity to bond with patients,” nurse navigator Maya Gantt said. “They’re more likely to reach out and connect with us for questions, which I think is so helpful.”


Where Data Makes a Difference

When patients reach out, providers can lean on biometric data collected by remote monitoring devices to improve their decision-making. Pruitt received her devices and learned how to use them before her surgery. McClain led a refresher course when Pruitt got home, helping her hook up biosensors to measure her oxygen levels, blood pressure, and weight. Wearable devices tracked her steps and sleep patterns.


Following a gentle learning curve, clinical insights flowed through the application to her care team at the hospital, helping them make evidence-based diagnoses and treatment decisions while building a reliable patient record.


“This gives me instant feedback,” Gantt said. “It just feels like better accuracy.”


No more asking patients to find the sticky note where they jotted down their blood pressure. And no more wondering whether they measured oxygen levels correctly, if at all. Remote monitoring fills the information void.


Moreover, seamless communication and remote monitoring minimize unnecessary trips to the hospital. Without the Perfect Care Program, Pruitt’s husband may have had to drive her to the clinic for tests if she reported feeling dizzy. But now, when patients call with a concern, care teams can remotely check their vitals, review their histories, run tests, and determine if a hospital visit is necessary. The firewall protects patients and health systems.


“It makes everything more effective when I can call them back and say, ‘I can see that your blood pressure is a little low. Let’s try to change this and fix this,’” Gantt said.


Prioritizing What’s Important

It’s been more than half a year since Pruitt’s open heart surgery. She doesn’t clutch her chest anymore. That “no big deal” flutter is gone for good. Instead of worrying about her heart, she’s focused on her dogs, her downstairs bedroom renovation, and her summer plans.


“I’m gonna live the best life that I can while I’m here,” she said.


As she looked back on her experience, Pruitt offered advice to patients preparing for cardiac surgery: The journey moves quickly, so start building a relationship with your nurse navigator early. Ask every silly question you have, because when it comes to your health, there are no silly questions.


“It gives you a lot more peace of mind,” she said.

That peace of mind is precious to Pruitt. She was no stranger to heart troubles before her annual checkup revealed the extensive blockages. Almost every member of her family suffered a heart attack before age 40, and none lived as long as she has.


“But there’s no sense living in fear,” she said.


Thanks to a connected recovery, she doesn’t need to.


 

On top of a wonderful patient experience, Atrium Health's Perfect Care delivers reduced readmissions and length of stay. Read about their organization's successes and improved care team experience.


Providing a better patient experience is a critical piece of your strategy. Here’s how to navigate the industry headwinds when making strategic technology decisions.



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