In general the optimal signal for managing HF patients would be one that tracks closely with filling pressure, is easily discernible and accurately measurable, is rapidly transmitted from the patient to the provider, is actionable/interpretable by a variety of clinicians, and is responsive, in that the intervention that is directed by the change of pressure produces a measurable change in the parameter so that the information–intervention feedback loop can then repeat.

Figure 15 displays the concept of a loop of remote monitoring where some data are transmitted upon action by the patient, the data are received and processed by a central provider, the patient is then contacted and implements an intervention, and then the response to that patient-initiated intervention can be detected so that further intervention can be implemented if needed.^[10]

Even with an effective signal of decompensation, it may not be possible to keep patients well and out of the hospital unless all elements of this information–intervention loop can be completed in an efficient fashion.