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  • 2022
  • Article
  • JACC: Advances

Investigating the Association Between Telemedicine Use and Timely Follow-Up Care After Acute Cardiovascular Hospital Encounters

By: Mitchell Tang, A Jay Holmgren, Erin E. McElrath, Ankeet S. Bhatt, Anubodh S. Varshney, Simin Gharib Lee, Muthiah Vaduganathan, Dale S. Adler and Robert S. Huckman
  • Format:Electronic
  • | Pages:12
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Abstract

Background: Telemedicine use increased dramatically during the COVID-19 pandemic; however, questions remain as to how telemedicine use impacts care.
Objectives: The purpose of this study was to examine the association of increased telemedicine use on rates of timely follow-up and unplanned readmission after acute cardiovascular hospital encounters.
Methods: We examined hospital encounters for acute coronary syndrome, arrhythmia disorders, heart failure (HF), and valvular heart disease from a large U.S., multisite, integrated academic health system among patients with established cardiovascular care within the system. We evaluated 14-day postdischarge follow-up and 30-day all-cause unplanned readmission rates for encounters from the pandemic “steady state” period from May 24, 2020 through December 31, 2020, when telemedicine use was high and compared them to those of encounters from the week-matched period in 2019 (May 26, 2019, through December 31, 2019), adjusting for patient and encounter characteristics.
Results: The study population included 6,026 hospital encounters. In the pandemic steady-state period, 40% of follow-ups after these encounters were conducted via telemedicine vs 0% during the week-matched period in 2019. Overall, 14-day follow-up rates increased from 41.7% to 44.9% (adjusted difference: +2.0 percentage points [pp], 95% CI: -1.1 to +5.1 pp, P = 0.20). HF encounters experienced the largest improvement from 50.1% to 55.5% (adjusted difference: +6.5 pp, 95% CI: +0.5 to +12.4 pp, P = 0.03). Overall 30-day all-cause unplanned readmission rates fell slightly, from 18.3% to 16.9% (adjusted difference -1.6 pp; 95% CI: -4.0 to +0.8 pp, P = 0.20).
Conclusions: Increased telemedicine use during the COVID-19 pandemic was associated with earlier follow-ups, particularly after HF encounters. Readmission rates did not increase, suggesting that the shift to telemedicine did not compromise care quality.

Keywords

Health Care; Telemedicine; Health Care and Treatment; Outcome or Result; Behavior; Health Industry; United States

Citation

Tang, Mitchell, A Jay Holmgren, Erin E. McElrath, Ankeet S. Bhatt, Anubodh S. Varshney, Simin Gharib Lee, Muthiah Vaduganathan, Dale S. Adler, and Robert S. Huckman. "Investigating the Association Between Telemedicine Use and Timely Follow-Up Care After Acute Cardiovascular Hospital Encounters." JACC: Advances 1, no. 5 (2022).
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About The Author

Robert S. Huckman

Technology and Operations Management
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More from the Authors
  • Building the Business Case for an Inclusive Approach to Digital Health Measurement with a Web App (Market Opportunity Calculator): Instrument Development Study By: Mitchell Tang, Yashoda Sharma, Jennifer C. Goldsack and Ariel Dora Stern
  • How to Tap the Full Potential of Telemedicine By: Mitchell Tang, Louise Short, Ryan June, Matthew Dowling and Ateev Mehrotra
  • The Brigham and Women’s Hospital Innovation Hub: Driving Internal Innovation By: Ariel Dora Stern, Robert S. Huckman and Sarah Mehta
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