October 6, 2020
ACC Quality Summit Virtual will feature several poster presentations on COVID-19 impacts within cardiology practice over the last several months. Research is focused on the sustainability of telehealth, health care disparities in heart failure patients, as well as the impact on patient-centered care and interventional cardiology.
Sustainability of Telehealth Post-Pandemic
As part of the initial response to COVID-19, many health care systems made a rapid expansion in the use of telehealth services to provide access to cardiovascular care. According to researchers at the Heart and Vascular Center at the University of California at San Francisco, their practice shifted from telehealth making up less than 10% of visits pre-pandemic to 80% of all visits in March 2020. Researchers assessed patient and provider telehealth experiences through chart reviews, interviewing patients and surveying providers within the Heart and Vascular Center, as well as using the Clinician and Groups Consumer Assessment of Healthcare Providers and Systems survey to determine patient satisfaction. Overall, 87% of interviewed patients would schedule another telehealth visit, while only 3% would not if the pandemic were not a concern. Both patients and providers concurred that follow-up visits are better suited for telehealth.
Racial and Ethnic Differences in COVID-19 Status of Heart Failure Patients
To determine which population was at greater need of intervention during COVID-19, researchers at Cook County Health – Stroger Hospital analyzed the data of heart failure patients admitted for COVID-19 infection between March 19 and May 27, 2020. As heart failure patients often have multiple co-morbidities—making them at higher risk during the COVID-19 pandemic—and health care resources are challenged by the pandemic, the hospital wanted to identify the people most in need of help and who will benefit not only from patient care but also from preventive care to maintain health. By analyzing demographic data from electronic health records of all heart failure patients admitted for COVID-19, the researchers determined most were African American (46.7%) or White Hispanic (36.7%) and 81% were male. According to the researchers, “this data may be the result of the unequal access to medical care, unequal living conditions and access to food and medication, or [a] combination of all of the above.” Therefore, male, African American and White Hispanic heart failure patients may be most benefitted by targeted education regarding minimizing exposures, use of personal protection (masks), hands washing and COVID-19 sick person isolation from other family members to save lives and maintain health.
Post-Surge Impact of COVID-19 on Patient-Centered Care
Reaction to the COVID-19 pandemic has led to an overhaul in how most health care is delivered and impacted most of the determinants of patient-centered care. Researchers at the State University of New York (SUNY) – Stony Brook University Hospital examined how post surge efforts
to control and contain COVID-19 have altered health care delivery and placed a burden on health care practitioners, systems and patients. The researchers interviewed patients admitted to the cardiology service and ranked concerns and suggestions by significance, frequency and potential for improvement for follow-up. The most frequent concerns mentioned by patients related to communication with physicians and staff, prevention and limitation of visitors and hospital staff, as well as feelings of isolation and fears of COVID-19 infection. The ability to meaningfully direct and decide on testing and treatments was strongly valued, particularly by patients feeling without control and hopeless. When being discharged patients strongly preferred going home to rehabilitation or nursing facility and valued telehealth options for follow-up visits.
Impact of COVID-19 on Interventional Cardiology in NY Epicenter
SUNY – Stony Brook University Hospital cared for approximately one-fourth of Suffolk County, New York, COVID-19 patients during the COVID-19 surge in Downstate New York and Long Island as one of the early U.S. epicenters. In hospitalized COVID-19 patients, a substantial percentage of patients demonstrate myocardial injury. There was also an increased representation of patients with cardiovascular risk factors and known disease in the hospitalized COVID-19 population. SUNY – Stony Brook University Hospital gathered a multidisciplinary committee to review catheterization and interventional cardiology cases during the pandemic surge to evaluate the impact of COVID-19 on volume, diagnosis, treatment and outcomes. The COVID-19 pandemic altered the baseline characteristics of patients undergoing cath and percutaneous coronary intervention. It was associated with significant morbidity and mortality.
