The role of telemedicine in healthcare is no longer limited to diagnosis and post-treatment follow-ups. It has found widespread application in specialties such as cardiology too.
Source: Cardiovascular Business
According to one recent finding, after telemedicine services were employed by the Veterans Health Administration post-cardiac arrest care program, hospital re-admissions decreased by 51% for heart failure.
Let’s look at a few ways telemedicine is making cardiac care more approachable and improving overall patient outcomes in cardiology.
1) Virtual Visits
Telemedicine consultations in case of initial and ongoing visits offer money- and time-saving benefits for patients who might not be living in the proximity of a Cardiologist. There are different types of telemedicine platforms available in the market today to suit the needs of every healthcare organization.
Joaquin E. Cigarroa, M.D., cardiologist at Oregon Health & Science University (OHSU) in Portland, has numerous patients who live on the coast. He examines both new and follow-up patients remotely and evaluates their condition by linking into systems at off-site facilities.
The experience reflects aspects of an in-person consultation in more than one way. “I get data equivalent to what I get in person, and the patients only have to come to Portland if they need a procedure, which isn’t very often. They don’t have to drive the wet, cold roads unnecessarily,” Dr. Cigarroa says.
Vicki Campbell, one of Dr. Cigarroa’s patients and a resident of Yachats, Oregon, got to experience these benefits firsthand. She used to drive three hours all the way to OHSU for tests but has since been able to seek consultation from her local doctor’s office for treatment of early heart failure.
“It’s like being in his office, just like being there with him,” says Campbell. “It was a lot less stressful, and it certainly saved me money. You don’t have to go through a lot of rigmarole getting ready to make a trip.”
Brian Plechaty from Depoe Bay, Oregon, also sought Dr Cigarroa’s remote consultation to see if he had a heart condition. His local physician and Dr Cigarroa coordinated blood work and tests before Plechaty met with the latter.
“What struck me as amazing was the quality of the picture on the screen. It’s like a very high-definition picture that you’d be hard-pressed to find in today’s TVs. It’s very crisp, really clear, almost like it’s real,” describes Plechaty. “It saved me a long drive. It’s a real traffic mess in Portland.”
Telemedicine technology facilitates effective remote patient examinations, strengthening the care provider’s instincts further.
“You don’t have the tactile sensation to feel pulses in the leg and to feel how warm the patient’s extremities are. So, you have to develop other senses,” Dr Cigarroa explains. “As telemedicine evolves, in addition to electronic stethoscopes, we’ll begin to use ultrasound technology, so although I can’t feel the arteries, I can see them.”
2) Connecting Patients to more Specialized Care Centers
Telemedicine is helping patients in small, rural hospitals by bridging the gap between them and larger, more specialized care centers. The transmission of echo-cardiograms, teleconsultations and other tests also allow general physicians to consult with specialists in real time for the diagnosis and treatment of heart conditions extending from cardiac arrest in adults right to congenital heart disease in newborns.
Source: Definitive Healthcare
For instance, in North Dakota’s rural areas, it’s extremely arduous for heart patients to be presented with timely care. Certain remote regions lack emergency or ICU care and specialists while others often experience doctor shortages.
However, with hospital-to-hospital care through telemedicine, if a patient feels breathless or has chest pain, he/she can easily get to a small local hospital, which can then set-up the said patient’s visit with a specialist via video.
On many occasions, patients can even be hospitalized in their rural hometowns while seeking treatment from an off-site Cardiologist. The specialists follow such patients through means of electronic monitoring equipment and prescribe appropriate intervention for the doctor and nurses in the on-site facility accordingly.
Real time ultrasound imaging transmission even enables cardiologists to direct Sonographers for diagnosis and treatment. Consequently, people can remain in their communities, in place of traveling to a large care center that might be located hundreds of miles away.
Source: Definitive Healthcare
3) Open-ended or Continual Monitoring
Following hospitalization, doctors can easily leverage telemedicine to monitor patients with heart failure.
Alfred Bove, Ph.D., past president of the American College of Cardiology, has been conducting extensive research on cardiology-related telemedicine since the late ‘90s.
Back in those days, this meant patients would send their pulse rate, blood pressure, and body weight to their providers via the Internet and a desktop computer. Today, the system relies on various IoT devices including smartwatches, mobile apps, smartphones, and voice recognition.
Patients dial an 800 number and recite their pulse, blood pressure, and body weight measurements. The system then translates that into numerical data for nurses or doctors to provide feedback to the patient.
The benefits for chronic disease management are far more evident now. “For conditions like heart failure, chronic angina, heart rhythm abnormalities, if one can keep them stable, the patient can stay better and health care won’t have as many acute care instances,” Dr. Bove says.
One recent study also shows that hospitalizations, ER visits, and total days spent in the hospital are comparatively lower for patients who use telemedicine reporting.
This telemedicine system is perfect for heart failure or hypertension patients; the ones who are steady on medication but need constant monitoring to maintain their health.
Physicians can easily keep track of daily or weekly changes and address an issue before it gets converted to a greater health concern. For example, if a patient starts retaining fluid, the doctor can see that in the numbers and adjust medication immediately.
“We need to educate patients on what the proper numbers should be and what it looks like if those numbers are out of whack. They have to be motivated to do it and have to report numbers once, twice a week, maybe more,” Dr. Bove says. “The technology is way ahead of us. We need to educate care teams and patients,” he adds.
“In the future, implanted devices will monitor levels, eliminating the need for patients to measure and report. When levels aren’t where they should be, the patient will receive a notification text message that includes instructions about what to do,” Dr Bove concludes.
4) Raising Compliance Rates for Cardiac Rehab
The use of telemedicine within cardiac care primarily seeks to achieve remote, real-time diagnosis and treatment of heart disease — including cardiac arrest, congestive heart failure, and arrhythmia.
One of the many ways it is doing this is by raising compliance rates for cardiac rehab, a medically supervised program designed to improve cardiovascular health after any event requiring care such as a heart attack.
Source: Cardiac Rehabilitation
“Making the effort is crucial: Cardiac rehab is “the only intervention that changes outcomes,” says Robert Berry, clinical coordinator of cardiac rehabilitation at Henry Ford Health System, which is part of the consortium.
Telemedicine removes the barriers of transportation to and from rehab appointments, a benefit for patients who live in rural areas or who don’t have physical capacity or assistance. Using a mobile app, patients can leverage the video capability of their phones or tablets to complete cardiac rehab from any location.
“From that point on, it really isn’t any different from any other cardiac rehab session that would be occurring in a brick-and-mortar facility,” Berry says. Henry Ford started the program in 2016 and offers it to low- and intermediate-risk individuals. About 15 to 20 percent of cardiac rehab patients across the Detroit-based health system now use it.
What Does the Future Hold?
Telemedicine holds the potential to easily meet the needs of today’s cardiologists and has the capacity to completely revolutionize the delivery of cardiac care.
It supports efforts to notably improve the quality of healthcare by increasing efficiency and accessibility through providing clinical support, reducing the need to travel, offering various types of communication devices, overcoming geographic barriers, and improving overall patient outcomes.
Thus, given the current focus on efforts to contain costs, meet consumer demand, and improve the delivery of care to all segments of the population, telemedicine is proving to be an effective tool to use for long term success in cardiac care.