{"id":40772,"date":"2022-11-14T12:07:38","date_gmt":"2022-11-14T17:07:38","guid":{"rendered":"https:\/\/mtelehealth.com\/?p=40772"},"modified":"2022-11-14T12:07:38","modified_gmt":"2022-11-14T17:07:38","slug":"telehealth-is-a-valuable-option-in-cardiovascular-care-though-challenges-remain","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/telehealth-is-a-valuable-option-in-cardiovascular-care-though-challenges-remain\/","title":{"rendered":"Telehealth is a valuable option in cardiovascular care, though challenges remain"},"content":{"rendered":"\n\n\n<p>New American Heart Association statement finds telehealth is effective for CVD care, however, issues like access to technology hinder widespread adoption<\/p>\n\n\n\n<p><strong>Statement Highlights:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Telehealth is an effective option for educating, diagnosing, monitoring and following people with health issues including cardiovascular disease.<\/li>\n\n\n\n<li>Telehealth may reduce health care costs, improve access to care in rural and under-resourced communities, and increase quality of care and patient satisfaction.<\/li>\n\n\n\n<li>Advances in technology have enabled telehealth\u2019s growth and improved accessibility to routine care.<\/li>\n\n\n\n<li>While the COVID-19 pandemic improved telehealth\u2019s infrastructure and increased its use, the pandemic also exposed limitations to its use for some people, such as limited resources to afford the technology, lack of internet bandwidth and language differences that may prevent people from using digital platforms to their fullest extent.<\/li>\n\n\n\n<li>Research into telehealth implementation barriers and addressing those will help ensure equitable, high-quality care for people with cardiovascular disease.<\/li>\n<\/ul>\n\n\n\n<p><strong>Embargoed until 4 a.m. CT\/5 a.m. ET Monday, Nov. 14, 2022<\/strong><\/p>\n\n\n\n<p>DALLAS, Nov. 14, 2022 \u2014 Telehealth is a proven and valuable option for people with cardiovascular disease, however, there are limitations to its use in rural and under-resourced communities, according to a new scientific statement from the American Heart Association, published today in the Association\u2019s flagship peer-reviewed journal&nbsp;<strong>Circulation<\/strong>. An American Heart Association scientific statement is an expert analysis of current research and may inform future treatment guidelines.<\/p>\n\n\n\n<p>Telehealth enables remote delivery of health care through technologies, such as structured telephone or video support and remote monitoring of wearable or implantable devices. This kind of technology-driven health care delivery&nbsp;<a href=\"https:\/\/www.heart.org\/en\/news\/2020\/03\/31\/video-doctor-visits-gain-ground-during-coronavirus-pandemic\" target=\"_blank\" rel=\"noreferrer noopener\">grew tremendously<\/a>&nbsp;during the COVID-19 pandemic, with up to 30% of all U.S. clinic visits conducted via telehealth in mid-2020\u2014showing interest in and capability of telehealth as a substitute for face-to-face patient care. However, data has shown its use has slowly declined as COVID-19 restrictions eased in late 2021.<\/p>\n\n\n\n<p>\u201cTelehealth is transforming the way health care is delivered by improving convenience and availability,\u201d said the statement\u2019s lead author Edwin A. Takahashi, M.D., an assistant professor of radiology in the division of interventional radiology at the Mayo Clinic College of Medicine in Rochester, Minnesota. \u201cHowever, we learned during the pandemic when we were forced to limit in-person care that there are limitations to using telehealth.\u201d<\/p>\n\n\n\n<p>This new scientific statement, \u201cAn Overview of Telehealth in the Management of Cardiovascular Disease,\u201d highlights the impact of telehealth in heart disease, stroke and peripheral artery disease (PAD) management, reviews strategies and obstacles for telehealth adoption in cardiovascular disease (CVD) care and identifies knowledge gaps.<\/p>\n\n\n\n<p><strong>The benefits of telehealth for CVD<\/strong><\/p>\n\n\n\n<p>The writing group\u2019s review found that telehealth may:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>reduce health care costs;<\/li>\n\n\n\n<li>improve access to care in rural and underserved areas; and<\/li>\n\n\n\n<li>increase care quality and patient satisfaction.<\/li>\n<\/ul>\n\n\n\n<p>These benefits are especially important for people with CVD, which disproportionately affects people from underrepresented racial and ethnic groups who often have additional barriers to health care and those with less access to medical care.<\/p>\n\n\n\n<p>Telehealth portals and smart devices may be cost-effective options for remotely managing conditions that are cardiac risk factors, such as high blood pressure and diseases like heart failure and coronary artery disease. \u201cTelestroke,\u201d the most studied area of telehealth in CVD, which is highly specialized stroke care delivered by first responders receiving instructions and guidance from remote stroke experts, often leads to improved rehabilitation and recovery for people who have had a stroke or may otherwise lack access to specialized stroke care.<\/p>\n\n\n\n<p><strong>The challenges of using telehealth<\/strong><\/p>\n\n\n\n<p>Challenges that may prevent more widespread telehealth use in CVD include barriers for both health care professionals and their patients.<\/p>\n\n\n\n<p>For health care professionals, the challenges identified are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>acceptance and uptake of telehealth technology, which may vary because of health care professionals\u2019 age, technology expertise and perceptions;<\/li>\n\n\n\n<li>inconsistent reimbursement and licensing matters (license requirements vary by state);<\/li>\n\n\n\n<li>logistical challenges in scheduling and maintaining workflow; and<\/li>\n\n\n\n<li>lack of infrastructure to analyze data from remotely monitored devices.<\/li>\n<\/ul>\n\n\n\n<p>Privacy and security are also key factors for professionals to consider. \u201cEven though most telehealth platforms are highly encrypted,\u201d Takahashi said, \u201cthey are not fully secure and may be at risk for data breaches.\u201d<\/p>\n\n\n\n<p>For people with CVD, the challenges identified are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>limited resources to access technology and devices for older adults and under-resourced populations;<\/li>\n\n\n\n<li>health literacy barriers, including cultural and language barriers that may prevent people from using digital platforms, consumer wearables and other devices to their full capacity; and<\/li>\n\n\n\n<li><a href=\"https:\/\/www.heart.org\/en\/news\/2020\/08\/05\/high-speed-internet-offers-key-connection-to-health-but-millions-lack-it\" target=\"_blank\" rel=\"noreferrer noopener\">insufficient access to internet bandwidth<\/a>&nbsp;for a high-quality video appointment.<\/li>\n<\/ul>\n\n\n\n<p>The statement asserts that the infrastructure for broadband internet needs to be improved, especially in rural areas that lack direct access to medical care, creating a \u201cmedical desert.\u201d<\/p>\n\n\n\n<p><strong>Strategies to overcome obstacles<\/strong><\/p>\n\n\n\n<p>Infrastructure, technology and reimbursement are the key areas to address barriers to telehealth use. For the approximately 25% of U.S. adults without broadband access, the statement suggests public policy changes may be helpful to supplement efforts by the private sector to expand affordability and access to internet services. An appraisal of current policy and identifying potential targets for policy reform are necessary, according to the writing group.<\/p>\n\n\n\n<p>As the country shifts back to in-person care, the statement encourages research into the role of telehealth beyond the pandemic. \u201cTelehealth has the potential to have a larger role in urgent diagnosis and remote monitoring,\u201d Takahashi said.<\/p>\n\n\n\n<p>However, reimbursement challenges need to be addressed, and simplified, as well. Not all insurance payers reimburse equally for in-person vs. telephone vs. video appointments, which ultimately lowers reimbursement for professionals who care for patients without video capability. And, as telehealth expands, there is a need for standards in how to assess the quality of telehealth care provided.<\/p>\n\n\n\n<p>\u201cTelehealth will play an important role in the future of cardiovascular care because the evolution of technology will enable new remote care opportunities to improve medical accessibility,\u201d Takahashi said. \u201cHopefully, this will have a strong benefit for patients from historically excluded and rural communities who often face health care disparities and are most at risk for cardiovascular diseases.\u201d<\/p>\n\n\n\n<p>As part of the American Heart Association\u2019s commitment to excellence in telehealth care, the Association acquired the American Board of Telehealth (ABT), a national entity that establishes best practices and standards for telemedicine education.&nbsp;<a href=\"https:\/\/www.heart.org\/en\/professional\/telehealth\" target=\"_blank\" rel=\"noreferrer noopener\">The American Board of Telehealth, powered by the American Heart Association<\/a>, aims to weave telemedicine into the fabric of health care delivery across the country as a vital tool in promoting access to quality care no matter where you are.<\/p>\n\n\n\n<p>This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention, the Council on Hypertension, the Council on the Kidney in Cardiovascular Disease, and the Stroke Council. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association\u2019s official clinical practice recommendations.<\/p>\n\n\n\n<p>Co-authors are Lee H. Schwamm, M.D.; Opeolu M. Adeoye, M.D., FAHA; Olamide Alabi, M.D.; Eiman Jahangir, M.D., FAHA; Sanjay Misra, M.D., FAHA; and Carolyn H. Still, Ph.D., M.S.M. Authors\u2019 disclosures are listed in the manuscript.<\/p>\n\n\n\n<p>The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers, and the Association\u2019s overall financial information are available&nbsp;<a href=\"https:\/\/www.heart.org\/en\/about-us\/aha-financial-information\" target=\"_blank\" rel=\"noreferrer noopener\">here<\/a>.<\/p>\n\n\n\n<p><strong>Additional Resources:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Available multimedia is on right column of release link&nbsp;<a href=\"https:\/\/newsroom.heart.org\/news\/telehealth-is-a-valuable-option-in-cardiovascular-care-though-challenges-remain\" rel=\"noreferrer noopener\" target=\"_blank\">https:\/\/newsroom.heart.org\/news\/telehealth-is-a-valuable-option-in-cardiovascular-care-though-challenges-remain<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/newsroom.heart.org\/news\/la-telemedicina-es-una-opcion-valiosa-para-la-atencion-cardiovascular-aunque-aun-quedan-desafios-por-superar?preview=ff7fbc2c2c2f4f1bd2860bf1f9e17c86\" rel=\"noreferrer noopener\" target=\"_blank\">Spanish news release<\/a><\/li>\n\n\n\n<li>After Nov. 14, view the&nbsp;<a href=\"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIR.0000000000001107\" target=\"_blank\" rel=\"noreferrer noopener\">manuscript online<\/a>.<\/li>\n\n\n\n<li>You\u2019re The Cure blog:&nbsp;<a href=\"https:\/\/www.yourethecure.org\/protecting_access_to_telehealth_services\" target=\"_blank\" rel=\"noreferrer noopener\">Protecting Access to Telehealth Services&nbsp;<\/a>(March 2022)<\/li>\n\n\n\n<li>AHA News article:&nbsp;<a href=\"https:\/\/www.heart.org\/en\/news\/2020\/07\/30\/are-virtual-doctor-visits-safe-for-discharged-heart-failure-patients\" target=\"_blank\" rel=\"noreferrer noopener\">Are virtual doctor visits safe for discharged heart failure patients?<\/a>&nbsp;(July 2020)<\/li>\n\n\n\n<li>AHA policy statement:&nbsp;<a href=\"https:\/\/professional.heart.org\/en\/science-news\/recommendations-for-the-implementation-of-telehealth-in-cardiovascular-and-stroke-care\" target=\"_blank\" rel=\"noreferrer noopener\">Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care&nbsp;<\/a>(Dec 2016)<\/li>\n\n\n\n<li>Follow AHA\/ASA news on Twitter&nbsp;<a href=\"https:\/\/twitter.com\/HeartNews\" target=\"_blank\" rel=\"noreferrer noopener\">@HeartNews<\/a><\/li>\n<\/ul>\n\n\n\n<p><strong>About the American Heart Association<\/strong><\/p>\n\n\n\n<p>The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public\u2019s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on&nbsp;<a href=\"http:\/\/www.heart.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">heart.org<\/a>,&nbsp;<a href=\"http:\/\/facebook.com\/AmericanHeart\" target=\"_blank\" rel=\"noreferrer noopener\">Facebook<\/a>,&nbsp;<a href=\"http:\/\/twitter.com\/American_Heart\" target=\"_blank\" rel=\"noreferrer noopener\">Twitter<\/a>&nbsp;or by calling 1-800-AHA-USA1.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>New American Heart Association statement finds telehealth is effective for CVD care, however, issues like 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