Access to Care Through Telecardiology

Telehealth is a remote or virtual healthcare delivery system and applies to most disciplines, including cardiology (telecardiology).. Telecardiology became popular during the COVID-19 pandemic when in-person patient-physician interactions were limited, especially in the outpatient setting. Healthcare providers in separate locations from their patients provide care through audiovisual equipment. Telecardiology use expanded during the pandemic, with one study reporting that >75% of outpatient visits in all cardiac subspecialties were virtual (95% in electrophysiology and < 25% for heart failure).¹

Telecardiology improves cardiovascular consultations, monitoring, triage, and treatment. In a 2022 systematic review, most international countries with telecardiology had prompt triage and management of acute coronary syndrome with early imaging (pre-hospital ECGs) and remote monitoring. ² A 2021 systematic review shows similar results with early cardiovascular disease diagnosis and treatment, resulting in mortality, cardiac event, and hospitalization rate reduction in 92% of the studies reported (N=32).³ This study also showed improved quality of life and patient satisfaction, though the results could not be compared to in-person visits.³ In a mixed-methods analysis of veteran attitudes towards telecardiology, most participants had “positive” attitudes towards telecardiology compared to in-person cardiovascular evaluations. ⁴ Telecardiology contributes to economic improvement in cardiovascular disease care. In the previously mentioned 2021 systematic review, 85% (N=21) of the studies evaluating cost benefits of telecardiology noted reductions in the cost of care, number of visits, and number of patients referred to specialized centers. ³

The Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040 – 117^th Congress) was recently passed by the House of Delegates on July 27, 2022. The bill allows federally qualified and rural health centers to serve as distant healthcare sites and beneficiaries to continue receiving telehealth services at any site until December 31, 2024.5 This bill extends Medicare telehealth flexibilities, helping those with limited access to care. Let us hope this bill receives support from the Senate, so patients continue to reap the benefits of telecardiology in the United States.

References.

1. Kalwani NM, Osmanlliu E, Parameswaran V, et al. Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic. Journal of Telemedicine and Telecare. Published online 2022. doi:10.1177/1357633X211073428
2. Yamano T, Kotani K, Kitano N, et al. Telecardiology in Rural Practice: Global Trends. International Journal of Environmental Research and Public Health. 2022;19(7). doi:10.3390/IJERPH19074335
3. Mohammadzadeh N, Rezayi S, Tanhapour M, Saeedi S. Telecardiology interventions for patients with cardiovascular Disease: A systematic review on characteristics and effects. International Journal of Medical Informatics. 2022;158:104663. doi:10.1016/J.IJMEDINF.2021.104663
4. Finley BA, Palitsky R, Charteris E, Pacheco C, Kapoor D. Outpatient telecardiology perceptions among rural, suburban, and urban veterans utilizing in-person cardiology versus telecardiology services: A mixed methods analysis. The Journal of Rural Health. 2021;37(4):812-820. doi:10.1111/JRH.12586
5. H.R.4040 – 117th Congress (2021-2022): Advancing Telehealth Beyond COVID–19 Act of 2021 | Congress.gov | Library of Congress. Accessed August 9, 2022. https://www.congress.gov/bill/117th-congress/house-bill/4040