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Our comprehensive Cardio@Home programs are made for you and focus on modifying lifestyle behaviors that relate to cardiovascular disease, such as physical activity, nutrition, stress management and more. Through a holistic approach, the programs are tailored to help your heart heal and improve your health and quality of life and achieve optimal recovery.

If you have one or more chronic conditions, let the Cardio@Home team at CIS
help you manage your health care from the comfort of your own home

  • How It Works
  • Program Benefits
  • How Do I Enroll
  • How It Works

    Cardio@Home communication may be via phone calls, texting, video or email. These frequent non-face-to-face visits could help reduce the need for you to come to the clinic for an in-person visit. For example, one of the programs can allow you to have a video session to review a new medication that was prescribed for you, rather than coming to the clinic for a visit.

    We work closely with each patient to develop a unique and personalized care plan to address your needs and manage your care based on your medical history and conditions. In addition to complete care coordination with your other healthcare providers, Cardio@Home offers the convenience of having open communication to allow us to better manage your care while keeping you at home. Patients can call their Cardio@Home team through a designated phone number at any time for things such as worsening symptoms, medication refills or assistance with getting an appointment with another health care provider. Cardio@Home is designed to be your one-stop-shop in health care.

  • Program Benefits

    Cardio@Home offers many benefits to patients which include:

    • Convenient access to your Cardio@Home physician and CCM care team through a designated phone number
    • Increased communication to help improve overall care coordination
    • 24/7 access to our CIS care team
    • Ability to offer other forms of communication such as texting, video or emailing for quick and easy access
    • Helps to improve quality of life by offering unique services such as social services and dietary support
    • Helps to reduce hospital admissions or readmissions
    • Reduces the need for frequent travel to doctor visits or unnecessary emergency room visits
    • Frequent medication review for patient safety
    • Continuity of care through your designated nurse navigator
    • More cost-effective option to manage your health
  • How Do I Enroll

    Your doctor may recommend that you enroll in one of the Cardio@Home programs at your clinic visit. However, you may also request to be enrolled at any time, as long as you have seen a CIS physician within one year. The Cardio@Home team will evaluate whether you qualify for the program. If you qualify, you will be asked to give written or verbal consent. Next, an initial visit will be scheduled to discuss the program and answer any questions you may have.

    WHO CAN BE ENROLLED IN CHRONIC CARE MANAGEMENT?

    All Medicare patients with one or more chronic conditions can be enrolled.

    These conditions may include, but are not limited to:

    • Atrial Fibrillation
    • Cardiovascular Disease
    • Coronary Artery Disease
    • Heart Failure
    • High Blood Pressure
    • High Cholesterol
    • Peripheral Artery Disease

    *Ask your physician or nurse if you qualify

    AFTER I ENROLL, CAN I CHOOSE NOT TO PARTICIPATE?

    Yes, all enrolled patients have the option to withdraw from the program at any time. Once you withdraw from the program, you will no longer receive communication or be managed by the Cardio@Home team.

    IS THERE A COST?

    Yes, depending on your insurance coverage, you may have a small monthly fee to be enrolled in the program. But keep in mind that this small monthly fee can reduce your need for regular visit co-pays or emergency room visits, while adding the convenience of managing your care from home.

The Cardio@Home Team at CIS

Your compassionate Cardio@Home team consists of CIS physicians,
nurse practitioners, nurse navigators, licensed social workers, as
well as registered dietitians.

Our Cardio@Home nurse navigators will be in close communication
with your CIS physician or nurse practitioner to ensure you are
receiving the best care possible. You can also access the CIS
Virtual Care Center for any after-hour urgent needs.

Cardio@Home Programs

Chronic Care Management

This program allows a CIS provider to connect with patients via non-face to face visits such as phone calls, emails, text messages and videos to help patients monitor their chronic conditions.

Remote Patient Monitoring

This program is similar to our Chronic Care Management program and patients are able to be cared for by our team from the convenience and comfort of their home. RPM enhances the monitoring by adding a home device, such as a Blood Pressure Cuff or weight scale. Patients complete a daily questionnaire then take their vital signs on the appropriate device. This information is sent to one of our nurses in the Virtual Care Center and the patient is monitored 24/7. This remote monitoring can last between 30-90 days, depending on the needs of the patient.Patients aged 20 years or older without established cardiovascular disease (CVD) should undergo periodic cardiovascular risk assessment every three to five years.

Remote Coumadin Monitoring

Our Coumadin monitoring process offers patients the capability to have their Coumadin checked in the comfort of their own home. This saves time, provides consistency and frequency of reporting, and offers easy integration with technology and electronic health records.

The advantages of self-monitoring include convenience and freedom for the patient, patient empowerment/control over their condition and treatment, and increased patient satisfaction--all of which may improve quality of life.

Principle Care Management

This program is for patients with one serious, chronic condition that has lasted for more than 3 months. Like Chronic Care Management, it allows patients to connect with their provider through phone calls, emails, text messages and videos to manage their condition. 

Transitional Care Management

Transitional Care Management (TCM) is a program offered to our patients to successfully transition them from the hospital to home, preventing any gaps in care and making for a successful transition home. When leaving the hospital, the patient may be dealing with a medical crisis, new diagnosis, or change in medication therapy, and TCM allows them the see their doctor within 72 hours to make sure their care plan is established and the patient feels safe and secure.

Bundled Payments for Care Improvement

The Bundled Payments for Care Improvement (BPCI) initiative was created by Medicare to reduce the overall cost of health care and increase quality and care coordination. Any Medicare patient who has a PCI procedure with CIS, will be enrolled in the program, and is monitored by nurses and care coordinators in the Virtual Care Center. The patient is monitored for 90 days and is linked to many services beyond just cardiac care and provides comprehensive care coordination.

Patient Testimonials

“I had truly felt like this past Christmas holiday was going to be my last with my mother, but the CCM team has given my mother her life back! I am confident she is in good hands. I am pleased with the services, personal care and compassion that my mother has received from the entire team.”

"After the dietician spoke to us about low-sodium diets, I lost five pounds in one month and my husband lost 17 pounds in one month!”

“My husband’s blood pressure was very high. I was always worried and stressed, but they were able to bring his BP down with medication adjustment. They are my angels.”

 

Contact Your Cardio@Home Team 24/7

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