Telehealth provided value for heart failure patients during COVID-19 pandemic
Telehealth follow-up appointments can boost care for heart failure (HF) patients, according to a new study published in the Journal of the American Heart Association.[1]
“During the early stages of the pandemic, many U.S. healthcare systems struggled to address the rapid surge in COVID‐19 cases and were forced to reallocate resources to treat the most critically ill patients,” wrote lead author Hanzhang Xu, PhD, a specialist with Duke University Medical Center, and colleagues. “Many patients with chronic conditions were also reluctant to seek care in person owing to fears of contracting COVID‐19 and/or concerns of inadequate health care resources. In response to these challenges, CMS and others updated their reimbursement policies to allow healthcare systems to implement telemedicine visits for patients requiring essential healthcare services and to help reduce transmission of the virus. As a result, many patients have been using telemedicine services to manage their disease as part of their routine medical care or during transitions of care.”
Xu et al. examined data from nearly 7,000 heart failure patients hospitalized from March 2020 to March 2021 in a single North Carolina health system. While 7.6% of patients received an early telehealth follow-up within 14 days of discharge, 38.8% received an early in-person follow-up. The remaining 53.6% did not receive any follow-up care within 14 days.
Overall, the team reported, the 30-day readmission rate for hospitalized HF patients was 19%. The rate varied from 15% for patients who received a telehealth follow-up, 14% for patients who received an in-person follow-up and 23.1% for patients with no follow-up care within 14 days.
When patients presented with mitral or aortic valvular disease, or underwent percutaneous coronary intervention, they were more likely to seek in-person follow-up care than turn to telehealth.
“It may be that these patients had more complex conditions that required physical assessments and/or laboratory testing from an outpatient visit,” the authors wrote. “Although there are concerns that some telemedicine visits such as phone calls may have not been sufficient to adequately monitor patients conditions, emerging evidence has suggested the feasibility and validity to perform physical assessments remotely.”
The team also emphasized that the COVID-19 pandemic, and those updated CMS reimbursement policies, made a significant impact on the use of telehealth. Just 0.3% of HF patients treated during a similar timeframe before the pandemic used telehealth for an early follow-up appointment — much lower than the 7.6% seen in this analysis.
Is this a sign that at-home telecardiology visits is something HF patients will embrace in the future?
“Telemedicine may provide a sustainable, cost‐effective, and patient‐centered approach for helping to reduce rehospitalization in patients with heart failure,” the authors wrote.
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.