LOS ANGELES (April 5, 2021) -- New research from the Smidt Heart Institute shows that more patients--specifically those with medical risk factors or from underserved communities--opted into telehealth appointments for their cardiovascular care during the COVID-19 pandemic. The data also suggests these telehealth patients underwent fewer diagnostic tests and received fewer medications than patients who saw their doctors in person.
The findings, published in JAMA (Journal of the American Medical Association) Network Open, point to "digital shifts" in cardiovascular care amid the ongoing COVID-19 pandemic.
"We were encouraged to learn that access to cardiovascular care was maintained for high-risk and underserved communities during the pandemic," said Joseph Ebinger, MD, director of Clinical Analytics in the Smidt Heart Institute and senior author of the study. "This same study, however, identified some differences in care that we need to delve into further to better understand."
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The researchers examined data collected from 87,182 pre-COVID in-person visits, 74,498 COVID-era in-person visits, 4,720 COVID-era telehealth video visits and 10,381 COVID-era telephone visits.
Across all categories, patients accessing COVID-era remote visits were more likely to be from racial or ethnic minority groups, have private insurance and have cardiovascular conditions such as hypertension, coronary artery disease, atrial fibrillation and heart failure.
Researchers then compared how often medications or follow-up tests, including electrocardiograms and echocardiograms, were ordered. Findings suggest a decrease when compared to pre-COVID visits.
"Our data reveal a reduced rate of testing and prescribing, likely due to a number of factors," said Ebinger. "We see these results as being not obviously negative or positive but a trend that is important to understand. For instance, lower rates of testing and prescribing may-in many instances-reflect reductions in the types of care that are not really needed to achieve good health outcomes while adding costs to the system."
Benefits and Pitfalls of Telehealth
One of the key benefits to telehealth visits, researchers say, is access to a cardiologist at a distance, which is vital for individuals who cannot--or do not want to--travel for care due to concerns over virus exposure, lack of transportation, increased family demands or inability to take time off of work. Without telehealth visits, Ebinger said, many of these patients may well not have received any healthcare at all.