@Article{info:doi/10.2196/29101,
author="Friedman, Daniel M
and Goldberg, Jana M
and Molinsky, Rebecca L
and Hanson, Mark A
and Casta{\~{n}}o, Adam
and Raza, Syed-Samar
and Janas, Nodar
and Celano, Peter
and Kapoor, Karen
and Telaraja, Jina
and Torres, Maria L
and Jain, Nayan
and Wessler, Jeffrey D",
title="A Virtual Cardiovascular Care Program for Prevention of Heart Failure Readmissions in a Skilled Nursing Facility Population: Retrospective Analysis",
journal="JMIR Cardio",
year="2021",
month="Jun",
day="1",
volume="5",
number="1",
pages="e29101",
keywords="heart failure; readmissions; skilled nursing facilities; posthospitalization; cardiovascular; cardiology; outcome; cost; virtual care; telehealth; telemedicine; mobile health; mHealth; digital health",
abstract="Background: Patients with heart failure (HF) in skilled nursing facilities (SNFs) have 30-day hospital readmission rates as high as 43{\%}. A virtual cardiovascular care program, consisting of patient selection, initial televisit, postconsultation care planning, and follow-up televisits, was developed and delivered by Heartbeat Health, Inc., a cardiovascular digital health company, to 11 SNFs (3510 beds) in New York. The impact of this program on the expected SNF 30-day HF readmission rate is unknown, particularly in the COVID-19 era. Objective: The aim of the study was to assess whether a virtual cardiovascular care program could reduce the 30-day hospital readmission rate for patients with HF discharged to SNF relative to the expected rate for this population. Methods: We performed a retrospective case review of SNF patients who received a virtual cardiology consultation between August 2020 and February 2021. Virtual cardiologists conducted 1 or more telemedicine visit via smartphone, tablet, or laptop for cardiac patients identified by a SNF care team. Postconsult care plans were communicated to SNF clinical staff. Patients included in this analysis had a preceding index admission for HF. Results: We observed lower hospital readmission among patients who received 1 or more virtual consultations compared with the expected readmission rate for both cardiac (3{\%} vs 10{\%}, respectively) and all-cause etiologies (18{\%} vs 27{\%}, respectively) in a population of 3510 patients admitted to SNF. A total of 185/3510 patients (5.27{\%}) received virtual cardiovascular care via the Heartbeat Health program, and 40 patients met study inclusion criteria and were analyzed, with 26 (65{\%}) requiring 1 televisit and 14 (35{\%}) requiring more than 1. Cost savings associated with this reduction in readmissions are estimated to be as high as US {\$}860 per patient. Conclusions: The investigation provides initial evidence for the potential effectiveness and efficiency of virtual and digitally enabled virtual cardiovascular care on 30-day hospital readmissions. Further research is warranted to optimize the use of novel virtual care programs to transform delivery of cardiovascular care to high-risk populations. ",
issn="2561-1011",
doi="10.2196/29101",
url="https://cardio.jmir.org/2021/1/e29101",
url="https://doi.org/10.2196/29101",
url="http://www.ncbi.nlm.nih.gov/pubmed/34061037"
}