Telecardiology Offers Immediate Care Option for Heart Patients

More than 800,000 Americans have a heart attack every year, and the chances of surviving a cardiac event are much higher the faster a patient can get to a doctor. The rising number of patients with cardiovascular issues, combined with the need to quickly serve patients in emergency situations, means hospitals must get creative about how they serve their communities.

Heart Disease Is Rising in the United States

Heart disease is the leading cause of death for men, women, and for people in most racial and ethnic groups. One in every four U.S. deaths annually is attributed to heart disease. But to understand the personal impact these statistics have on families, let’s break down the numbers a bit more.

According to the U.S. Centers for Disease Control and Prevention, one person dies every 36 seconds in the United States from cardiovascular disease. Additionally, someone has a heart attack every 40 seconds.

Americans are worse off than their counterparts across the globe. According to the American Heart Association (AHA), nearly half of all adults in the United States have cardiovascular disease. Cardiovascular health-related death rates are decreasing around the world but they are rising in the United States. Americans are smoking less and exercising more, the AHA says, but obesity and sleep deprivation are still significant risk factors for cardiovascular disease.

These rising numbers take a toll on families, health systems and the economy. According to the U.S. Department of Health and Human Services, heart disease and strokes cost the United States an estimated $316.6 billion in healthcare costs and lost productivity.

In order to deliver better access to patients and save healthcare spending across the board, telecardiology is an important virtual healthcare solution to consider. Telecardiology can help more patients get the care they need, closer to home.

How Does Telecardiology Work?

Using real-time audio/video and appropriate peripheral devices such as a stethoscope, virtual healthcare specialists provide consultations to on-site providers and patients in the emergency department and on the inpatient floor. A comprehensive telecardiology service will include equipment, IT support, cardiac workflows, on-site protocol training, cardiology-specific training for nurses, and monthly quality assurance and reporting.

Telecardiology programs also offer evidence-based workflows for the treatment, stabilization and management of chief cardiology diagnoses such as chest pain, heart failure and all arrhythmias. The telecardiologist also will provide data on quality metrics such as transfer rate, response time and patient satisfaction.

By potentially reducing transfer rates, access to a virtual cardiologist gives hospitals the chance to keep more patients closer to home by reducing unnecessary transfers. Telecardiology also helps support local physicians who are sometimes alone when taking care of complex, cardiac patients in the local community.

At-home telecardiology programs help patients focus on modifying lifestyle behaviors that relate to cardiovascular disease, such as physical activity, nutrition, stress management and sleep. Through a holistic approach, these programs offer options that are tailored to help patients’ heart health, improve their overall health and quality of life, or achieve optimal recovery after a cardiac event. They also can help patients managing high cholesterol or facing heart failure.

Remote monitoring has become the national standard of care for patients receiving cardiac rhythm management devices. These programs allow cardiologists to constantly monitor patients and ensure they are receiving the very best care. Studies show that remote monitoring increases survival rates and reduces emergency department visits, re-hospitalization, length of hospital stay and office visits.

How Long Does It Take to See a Cardiologist Virtually?

Virtual healthcare not only makes quality, expert care accessible to more people — it can be used to reduce patient wait times. Generally, a cardiologist situated remotely can consult with the patient and on-site clinician within 30 minutes.

Telecardiology also helps keep patients in their communities. Envision’s preferred telecardiology partner, Cardiovascular Institute of the South (CIS), has been able to keep 74 percent of cardiovascular patients in the health system where they began.

The ability to remain closer to family and to one’s primary care physicians results in happier and healthier patients. In fact, CIS ranks in the 96th percentile for patient satisfaction among all hospital programs. By connecting hospitals with world-class cardiologists, patients have better access to specialized care, physicians have more access to the care continuum, and health systems have the ability to keep patients in their community.

Telecardiology Programs Are a Lifeline for Rural Hospitals

Telecardiology programs, and virtual healthcare programs in general, give patients access to quality care when and where they need it most.

As the number of patients with heart disease grows, the number of cardiologists available to treat them is decreasing, particularly in rural areas that have a more difficult time attracting specialists. The results are devastating for patients — and for hospitals. When high-risk cardiac patients come into a low census emergency department, they often end up being moved to a facility with more specialized care.

By using virtual healthcare technology to connect clinicians to world-class specialists, telecardiology can allow patients to remain in their communities. That means loved ones can stay at their bedside without having to travel miles every day.

Telecardiology programs also help hospital systems manage bed capacity. With hub-and-spoke health systems, the flagship hospital can sometimes have a difficult time managing bed capacity, being inundated with patients needing a higher level of care. Combined with the nationwide nursing shortage, this problem can often lead to the emergency department being on diversion. In some cases, patients who present inside the systems end up being treated at a competing hospital.

By connecting satellite hospitals with telecardiology services, patients not only stay in their community, they also stay within the system and receive innovative, world-class care in the process.

One Patient’s Story: Telecardiology Offers Quality, Immediate Care

Patients and providers are often initially skeptical of virtual healthcare programs, especially when it comes to trauma and heart attacks. When they see telecardiology and virtual critical care programs in action, however, minds change quickly.

Take Mary Pierce, 76, who was scheduled to take her first trip to New York. At a family dinner shortly before she was to leave, Mary began experiencing lightheadedness, chest pressure and palpitations. She went to the emergency department where a physician administered several IV medications, but could not lower her heart rate or convert her to sinus rhythm.

The clinician ordered telecardiology consult from CIS. From about 90 miles way, a CIS cardiologist beamed in and saw Mary within 15 minutes. A number of family members also accompanied Mary into the exam room, telling the doctor how much Mary had been looking forward to vacation.

Recognizing Mary’s heart distress — but also her sadness at the prospect of missing out on family time — the CIS telecardiologist offered two options: immediate cardioversion that would likely provide instant symptom relief, or continuing IV medication at the hospital.

Mary chose cardioversion with the telecardiologist by her bedside the whole time. The procedure worked, and Mary recovered quickly and made it to New York. She said, “I was in awe! I had a cardiologist right there in the room with me. He could read all of my symptoms and even listen to my heartbeat.” The benefits of telecardiology were enormous for Mary, and for her family.

How Does Telecardiology Help Overburdened Clinicians?

The United States faces a systemic clinician shortage that will only continue to grow in the future. Forty-two percent of all physicians are 55 years old and older. Within cardiology, that number is even higher, with more than 50 percent of the nation’s cardiologists age 55 or older.

According to the American College of Cardiology’s 2019 Burnout Study, more than one-third (35.4 percent) of U.S. cardiologists reported feelings of burnout and nearly half (43.9 percent) reported feeling stressed. One-quarter of cardiologists who cited burnout said they experienced one or more symptoms, including physical or emotional exhaustion, a feeling of lack of accomplishment, and cynicism or detachment .

The number one problem affecting cardiologists is call. With telecardiology, hospitals can preserve the careers of many hometown and hospital-employed cardiologists by removing the call burden during nights and weekends. And, just as it does for families whose loved ones get to stay close to home, virtual healthcare services can reduce clinician travel time.

Jacob Corbell, CIS Executive Vice President of Business Development, has described how telecardiology programs can help reduce clinician burnout. Corbell discussed one cardiologist who had been traveling 45 minutes to round on a single patient. With digital healthcare tools, that physician could use a two-way audio/visual device to connect with his charge. When he did, “his quality of life has improved tremendously,” Corbell said.

How Did Virtual Health Help Hospitals During COVID Crisis?

Telecardiology and other virtual healthcare platforms were especially useful in the early days of the COVID-19 pandemic.

According to a report from Yale New Haven Health System (YNHHS), overall visits to YNHHS emergency departments were down about 40 percent during the first two months of the COVID-19 crisis. A report from Kaiser Permanente estimated U.S. emergency rooms saw about half as many heart attack patients as usual in the early days of the pandemic. The American Heart Association became so concerned about the phenomenon that it ran ads to convince Americans to call 911 if they were having symptoms of a heart attack or stroke.

While telecardiology platforms often do not eliminate the need to go to the ED, CIS utilized its virtual healthcare capabilities to provide telecardiology visits to patients in their homes during the COVID-19 pandemic.

It also can be used to separate patients by symptom in order to reduce COVID exposure. Envision quickly stood up drive-thru testing sites and administered testing to first responders and community members. Throughout the country, we also expanded and accelerated virtual healthcare capabilities to help mitigate the spread of COVID-19 and protect patients and clinicians. Teams provided care via tele-triage appointments, enabling them to evaluate a patient while observing social distancing in the hospital.

Envision’s office-based practices also increased their virtual health offerings to patients to ensure continuity of care during the pandemic. Between March and the end of the year, we provided nearly 250,000 virtual health visits.

Rest Easier with Telecardiology

One of the greatest risk factors for heart disease is stress and lack of sleep. Virtual healthcare solutions, and telecardiology, cannot eliminate either of these problems, but they can help patients, their families and their hometown clinicians rest easier, closer to home.