What is teleCardiology?

TeleCardiology is the diagnosis and treatment of disorders of the heart, such as congenital heart defects, coronary artery disease, and heart failure by a remote clinician using technology like videoconferencing. It makes it possible for a cardiologist and patient to be in separate rooms, cities, states or even countries and still be connected face-to-face. TeleCardiologists can work with onsite staff to help manage patients experiencing varying cardiac issues, such as arrhythmia, heart failure and chest pain.

How does teleCardiology work in a hospital?

When a patient with a cardiac condition arrives at the ED, they can expect to give blood for tests, get an IV, and undergo tests, such as an electrocardiogram (EKG). They will be monitored for abnormal heart rhythms. A cardiologist reviews the lab work and test results, then examines the patient, via a telemedicine cart. After discussion with the patient and onsite staff, the cardiologist makes recommendations for treatment, which may include medication, catheterization, or heart surgery.

Once a patient is admitted, cardiologists can continue to see them virtually, as well as use teleCardiology for follow up visits.

Why is the use of teleCardiology growing?

The aging population drives the prevalence of cardiovascular disease. For example, while approximately 2.4% of the overall population has heart failure, almost 12% of men and women over 80 years or older do. As the population of people over 65 grows, cardiovascular disease will increase accordingly.

Other reasons for the increasing prevalence of cardiovascular disease are increase in risk factors, such as hypertension (high blood pressure), and coronary artery disease. These conditions are occurring at younger ages, creating a longer time for the development of heart disease. Calcific aortic stenosis (hardening of the arteries) and impaired cardiac relaxation increase heart failure prevalence in older populations, as well.

At the same time the prevalence of cardiovascular disease is increasing, the supply of cardiologists is decreasing. A Health Affairs report showed the demand for cardiologists will increase as much as 18% annually through 2025. Nearly 60% of cardiologists are 55 and over and the rate of retirement is faster than new cardiologists are entering practice. Because of these shortages, hospitals are having trouble recruiting and retaining cardiologists. TeleCardiologists, who can practice from anywhere, are filling the gap in hospitals nationwide.

How teleCardiology can reduce transfers

Generally, in smaller hospitals, cardiac issues can often be the primary reason for transfer. Many of these patients only need a consultation to determine whether they can be retained and treated close to home, and avoid the disruption of transfer to a tertiary hospital.  Additionally, community hospitals may also be in need of a solution for patients who do not require invasive treatment and procedures and can benefit from a teleCardiology consultation. TeleCardiology services, which operate 24/7, provide board certified expert cardiologists who can support hospitalists and internists, as well as Emergency Department physicians in the management of these patients.

What are the benefits of teleCardiology?

Improved care for cardiac patients

  • Increased access to specialists not otherwise locally available
  • Faster response times to see patients during a cardiac event
  • Reduced waiting times for conducting necessary procedures

Increased throughput in the ED

  • Increased access allows for more efficient patient treatment

Higher patient and provider satisfaction

  • Patients receive quality cardiac care in their local hospital instead of being transferred out of their community
  • Providers who work the day shift can have relief on nights and weekends for better quality of life; this aids hospitals in keeping the cardiologists they have

Improved financial position

  • Reduction of patient transfers
  • Reduction of locum tenens and recruiting costs
  • Increased revenue by retaining patients
  • Reduced average length of stay (ALOS)

Conclusion

TeleCardiology is an efficient use of scarce clinical resources. With an aging population, an increase in the number of patients with cardiovascular disease, and a decrease in the number of cardiologists, teleCardiology can fill a gap for cardiac care. By using teleCardiology, hospitals can retain more patients and more revenue.  Augmenting with teleCardiologists for nighttime or weekend coverage can provide their own physicians with a better quality of life.

Additional Resources

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