Standardized telehealth framework increases patient access to cardiologists
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Implementing a structured cardiology telehealth framework increased patient access to cardiologists by more than 200%, with participating providers reported increased confidence in delivering virtual care, researchers reported.
The researchers presented their findings at the American College of Cardiology Cardiovascular Summit.
“Telehealth may be a new experience for everyone involved and knowing how to optimally provide this service to patients takes time and practice,” Tala Fanek, FNP-BC, associate director of clinical services at Novocardia, and Katherine Evans, DNP, FAANP, chief nursing officer and senior vice president of clinical services at Novocardia, told Healio. “Our standardized, structured and evidence-based framework for telehealth provided both the practice and patients to have the tools for success, which we defined as increasing patients’ access to their cardiologists.”
In February 2022, Fanek, Evans and colleagues implemented a structured, patient-centered telehealth service within a multisite CV practice in Jacksonville, Florida, which rapidly adopted “fragmented” virtual tools during the COVID-19 pandemic to meet patient needs, the authors wrote in an abstract. Decision support tools were built for front desk staff to schedule appropriate patients for telehealth. A “best practices” playbook outlined expected roles for each phase of the visit. In-depth provider education included appropriate patient selection, a guide to performing a virtual cardiology assessment and applying virtual bedside manners. The framework also included a telehealth note template with patient consent created for compliance and consistent documentation, using Doxy.me.
To improve visual and sound quality, iPads and headsets were provided for staff and providers. The telehealth workflow launched in June 2022, with analysis conducted between March 2020 and December 2022.
From March 18, 2020, to June 25, 2022, there were 2,280 telehealth visits, or 87 visits per month. There were 1,658 telehealth visits between June 27, 2022, and Dec. 30, 2022, or 276 visits per month.
Since July 2022, telehealth visits sustained more than 250 appointments each month. Telehealth visits increased by 217%, demonstrating improved patient access to cardiology providers.
Patient and provider satisfaction scores are pending survey results, according to the researchers. However, qualitative provider results demonstrated increased confidence in delivering appropriate, evidence-based virtual care.
Limitations to the framework adoption included broadband access in northeastern Florida for some patients, change acceptance and slower adoption within a multi-site practice.
“There are several clinical implications learned from this quality improvement study,” Fanek and Evans told Healio. “First, telehealth can effectively improve patient access to cardiology care. Second, using an optimized, evidence-based model for cardiology telehealth services, which includes best practices and a streamlined workflow, can empower and enable cardiologists and patients to embrace telehealth more readily. Third, when telehealth is offered as an efficient alternative to in-person visits, patients will want to continue utilizing the service as reflected in the number of telehealth appointments each month.”
Fanek noted that telehealth is important for improving access to health care, but there is work to be done in learning how to best provide this service to patients effectively and efficiently.
“Further understanding of the patient experience, provider experience and identifying gaps in telehealth are critical,” Fanek and Evans told Healio. “It is also important to understand which patients to engage, what are the barriers to telehealth, and what types of visits are most effective. Additionally, quality measures of telehealth are needed to ensure the highest clinical outcomes.”
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Fanek T, et al. Posters. Presented at: American College of Cardiology Cardiovascular Summit; Feb. 16-18, 2023; Washington.
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