Telecardiology: Heart Health at Home

As humans, every decision we make impacts our health in some aspect.  The old phrase “an apple a day keeps the doctor away”, reminds us that healthy eating habits reduce the frequency of getting sick.  Similarly – diet, exercise, and specialized medical care are ways to improve cardiac health, but some cardiac issues require more intensive measures.  Telemedicine can address cardiac problems quickly and maximize the impact of early decision-making.

Benefits of Cardiac Care

Cardiac telemedicine, known as telecardiology, aims to assist patients in their cardiac care regimen by monitoring existing heart conditions, diverting patients to emergency services as needed, and advising patients on their condition’s status.

Tiny abnormalities can lead to big problems requiring immediate attention.  Consider an irregular pulse, palpitations, or a fast heartbeat. Often times, this is a common, non-urgent abnormality, possibly signifying stress or a blood pressure-related issue.  However, in extreme cases, it could possibly be a sign of atrial fibrillation – a precursor to heart disease.  Using telemedicine, a patient experiencing cardiac irregularities can speak to a doctor immediately through video conferencing.  This immediate access to a cardiac physician is paramount, as guidance to the emergency room, or divergence from, is critical for many patients.  If patients are having specific symptoms, they should immediately dial 9-1-1, and optimally receive treatment in under 10 minutes.  However, that’s not the circumstance for all patients.

Telemedicine does not serve as a substitute for emergency medical attention.  However, for patients who don’t require a visit to an emergency room, though, avoiding the trip can save them upwards of $20,000. The objective of telecardiology is to increase patient access to cardiologists for non-life threatening situations, stay up to date on prescriptions and adjustments, and increase knowledge regarding their cardiac health so they know how to proceed when something feels abnormal.

Supporting Data

The American Heart Association (AHA) acknowledges the role of telehealth plays in advancing care in cardiovascular disease (CVD) – whilst addressing barriers to telehealth implementation, and strategies to overcome these barriers.  According to their figures, CVD exceeds costs of $350 billion per year in the United States, and will likely balloon to almost $1 trillion by 2030.  By increasing access, telemedicine removes barriers for patients with CVD and bridges the gap to specialty care where it may otherwise be unavailable and reduces these extreme costs.  “These programs improve the health and recovery of patients with CVD and substantially reduce hospital readmissions and associated costs,” the organization notes. Heart disease can take many forms and be progressive without overt symptoms, hence, early intervention and observation methods are critical for effective treatment.

Technology

There are numerous technological applications for telecardiology, for example, store-and-forward is a popular way to amplify the treatment of patients.  By electronically sending images and transmitting them to cardiologists, diagnoses delivery is faster, followed by recommendations and treatments as needed.  As rural areas experience significant cardiologist shortages, store-and-forward can exponentially improve the quality of care offered.

Remote patient monitoring (RPM) is also a common application of telemedicine in general, and specifically within telecardiology.  Using sensors and monitoring devices, such as ICD pacemakers, etc., in combination with data transmission technology, patients can submit vitals electronically and physicians can contact them in case of concern.  Additionally, transitional RPM programs can reduce readmission rates for heart failure patients, moving from inpatient to outpatient settings.

Success Stories

Hospitals throughout the nation have started implementing telecardiology.  Frederick Memorial Hospital adopted a telemedicine program as part of its Chronic Care Management Program, including chronic heart failure and cardiovascular diseases.  Patients used biometric devices with Bluetooth capabilities to remotely submit vitals to hospital staff through tablets. In the first 30 days of the trial, hospitals readmissions fell by 89% and emergency department visits dropped by 49%.  Chronic care patients had direct access to qualified personnel through their technology.  This access allowed immediate advisement on when to seek hospital services and when to stay home.  Additionally, these patients set long-term care goals using data from telemonitors and increased their overall health prospects.

Reimbursement

Overall inconsistencies in coverage and lack of reimbursement for telemedicine have been plaguing the industry for years.  Fortunately, that is beginning to change as more states are introducing telehealth parity laws, Medicaid parity laws, and telemedical technologies are improving.  Reimbursement for telecardiology is particularly noteworthy for store-and-forward and RPM, both of which are increasing in popularity and thus reimbursement opportunities.  There are still opportunities for improvement as state laws may vary. For more information on reimbursement options, click the VisuWell State Reimbursement Map.

Heart disease is the leading cause of death in the U.S., and cardiovascular diseases play a significant role in morbidity and disabilities.  Telecardiology can help providers in the U.S. reach more patients with increased comprehensive cardiac care in remote areas or patients who require on-the-spot specialty care.  The stakes in cardiac care are high, and innovative solutions have the potential to provide cost-effective methods for life-saving measures.

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