Multidisciplinary Team Approach in the Care of Patients with Heart Failure

The concept to utilize a multidisciplinary team approach in the care of patients with heart failure (HF) has been advocated for years by (inter-)national guidelines, but suffers from insufficient implementation. Up to now, in the German health care system, a guide for the composition of these teams has only been proposed for the highly specialized area (i.e., the so-called heart teams or HF teams), while respective blueprints do not exist for the outpatient sector. To improve the care situation of HF patients, the German Cardiac Society and the German Society of Thoracic and Heart Surgery had introduced in the year 2016 the concept of HF networks. However, these focussed on the cardiological-cardiosurgical intersectoral care areas. In order to integrate primary care providers into the network, this concept needs to be expanded and individually adjusted according to regional needs and care structures. For the interaction of the various care providers, a common communication platform including an electronic case file is indispensable. The currently planned "Disease Management Programme Heart Failure" could strengthen such structured interdisciplinary interaction by requesting it as an obligatory element and incentivize it appropriately.