Circulation: Heart Failure<\/em> offers a first-hand account of how one facility faced the pandemic head-on, embracing telehealth to ensure patients with advanced heart failure (HF) received the high-quality care they deserve. <\/p>\n\n\n\n\u201cAt our institution, we balanced the deferred\/cancelled face-to-face HF visits with rapid adoption of virtual visits\u2014from zero to 159 in five weeks\u2014while employing several novel virtual health technologies with overall positive results,\u201d wrote co-authors Aws Almufleh, MBBS, MPH, and Michael M. Givertz, MD, of Brigham and Women\u2019s Hospital in Boston. <\/p>\n\n\n\n
These are three key recommendations from the duo\u2019s commentary: <\/p>\n\n\n\n
1. Determine when urgent care patients need to come in and when they can stay at home<\/strong><\/p>\n\n\n\nUrgent care patients \u201cwith concerning symptoms\u201d were greeted with an automated tool that could determine if they truly needed to be seen in person\u2014or if they could simply see someone virtually. When patients responded to key questions, the tool would help determine the next necessary step. <\/p>\n\n\n\n
\u201cBy providing safe virtual options to seek medical treatment, patients are more likely to promptly access the needed care while reducing unnecessary\u2014and at times risky\u2014ED visits,\u201d the authors wrote. <\/p>\n\n\n\n
2. Design solutions with \u2018less tech-savvy patients\u2019 in mind<\/strong><\/p>\n\n\n\nWhen outpatient in-house appointments were replaced with virtual visits, the authors noted, it was important to consider the needs of \u201colder and less tech-savvy patients.\u201d In those instances, a caregiver or support staff employee was used as necessary to review all patient information and confirm medications before any virtual visit needed to take place. <\/p>\n\n\n\n
\u201cFurthermore, virtual visits are enhanced by integrating remote patient monitoring data (including weight and blood pressure),\u201d according to Almufleh and Givertz. \u201cIn fact, trended home vital signs may provide a better gauge for guideline-directed medical therapy optimization as opposed to the snapshots obtained during face-to-face encounters which are susceptible to multiple sources of error.\u201d<\/p>\n\n\n\n
3. Remain careful and vigilant when HF patients may have COVID-19<\/strong><\/p>\n\n\n\nPoint-of-care ultrasound (POCUS) equipment should be available for instances when inpatients present with potential COVID-related cardiac issues. The authors noted that a pilot program was launched that involved training residents on the basics of POCUS, allowing them to perform basic examinations and send the results directly to HF specialists.<\/p>\n\n\n\n
\u201cImportantly, because most hospitals have restricted visitor access during COVID-19, the use of in-room video conferencing with patients and family can be instrumental in facilitating critical conversations, including treatment decisions and advanced care planning,\u201d the authors wrote. \u201cUpon discharge, early follow-up can be arranged via telemedicine to ensure safe transition of care, monitor adherence, and uptitrate guideline-directed medical therapy after establishing clinical stability and resolution of congestion.\u201d<\/p>\n\n\n\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
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