Initial Outcomes of CardioClick, a Telehealth Program for Preventive Cardiac Care: Observational Study

Abstract

Background Telehealth use has increased in specialty clinics, but there is limited evidence on the outcomes of telehealth in primary cardiovascular disease (CVD) prevention. Objective The objective of this study was to evaluate the initial outcomes of CardioClick, a telehealth primary CVD prevention program. Methods In 2017, the Stanford South Asian Translational Heart Initiative (a preventive cardiology clinic focused on high-risk South Asian patients) introduced CardioClick, which is a clinical pathway replacing in-person follow-up visits with video visits. We assessed patient engagement and changes in CVD risk factors in CardioClick patients and in a historical in-person cohort from the same clinic. Results In this study, 118 CardioClick patients and 441 patients who received in-person care were included. CardioClick patients were more likely to complete the clinic’s CVD prevention program (76/118, 64.4% vs 173/441, 39.2%, respectively; P<.001) and they did so in lesser time (mean, 250 days vs 307 days, respectively; P<.001) than the patients in the historical in-person cohort. Patients who completed the CardioClick program achieved reductions in CVD risk factors, including blood pressure, lipid concentrations, and BMI, which matched or exceeded those observed in the historical in-person cohort. Conclusions Telehealth can be used to deliver care effectively in a preventive cardiology clinic setting and may result in increased patient engagement. Further studies on telehealth outcomes are needed to determine the optimal role of virtual care models across diverse preventive medicine clinics.

Application of the Quadruple Aim to evaluate the operational impact of a telemedicine program

“…It has been demonstrated previously that patient health outcomes from CardioClick matched or exceeded those achieved with in-person care. 21 In this analysis, we found that the Quadruple Aim provides a framework to quantify the operational benefits of CardioClick in comparison to traditional in-person care in the domains of efficiency (cost), patient experience, and clinician experience.…”

Drivers of variation in telemedicine use during the COVID-19 pandemic: The experience of a large academic cardiovascular practice

“…Telehealth programs have the potential to improve patient outcomes and satisfaction, enable operational efficiency, reduce the brick and mortar costs of in-person care, and expand the reach of specialized care. 16 – 20 Furthermore, the flexibility to offer services remotely may provide a better work-life balance for clinicians. It may also decrease clinician burnout, as telemedicine visits tend to be shorter in duration than in-person visits, giving clinicians more time to complete their visit notes.…”

“…For example, telemedicine visits were associated with greater program completion and engagement when compared to in-person visits. 16 Moreover, implicit clinician bias can contribute to inequitable virtual care access among historically marginalized groups, further widening health disparities.…”

“…In 2017, SHC implemented CardioClick, a telemedicine program providing video follow-up visits in one preventive cardiology clinic. 16 In 4 March 2020 the governor of California declared a state of emergency in light of rising COVID-19 cases and the first death in the state attributed to the disease. In the following weeks, SHC rapidly deployed telephone and video visits to allow for the continued delivery of outpatient services.…”

Parsley Health: Feasibility and acceptability of a large-scale holistic telehealth program for chronic disease care

“…Telehealth, or the use of technology to deliver resources and health care services, has proven to be an effective way to deliver chronic care programs in a traditional health care setting ( 18 ). Telehealth strategies can overcome many time and resource constraints by supporting more collaborative disease management, increasing patient engagement, improving patient self-management of conditions, decreasing medication use and hospital visits, and lowering healthcare spending ( 19 – 21 ). However, the use of telehealth for chronic disease management is still an emerging trend, despite explosive growth since the start of the COVID-19 pandemic and a growing desire among patients/consumers to be more active in their care, and for more care options.…”