TY  - JOUR
AU  - Friedman, Daniel M
AU  - Goldberg, Jana M
AU  - Molinsky, Rebecca L
AU  - Hanson, Mark A
AU  - Castaño, Adam
AU  - Raza, Syed-Samar
AU  - Janas, Nodar
AU  - Celano, Peter
AU  - Kapoor, Karen
AU  - Telaraja, Jina
AU  - Torres, Maria L
AU  - Jain, Nayan
AU  - Wessler, Jeffrey D
PY  - 2021
DA  - 2021/6/1
TI  - A Virtual Cardiovascular Care Program for Prevention of Heart Failure Readmissions in a Skilled Nursing Facility Population: Retrospective Analysis
JO  - JMIR Cardio
SP  - e29101
VL  - 5
IS  - 1
KW  - heart failure
KW  - readmissions
KW  - skilled nursing facilities
KW  - posthospitalization
KW  - cardiovascular
KW  - cardiology
KW  - outcome
KW  - cost
KW  - virtual care
KW  - telehealth
KW  - telemedicine
KW  - mobile health
KW  - mHealth
KW  - digital health
AB  - 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. 
SN  - 2561-1011
UR  - https://cardio.jmir.org/2021/1/e29101
UR  - https://doi.org/10.2196/29101
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34061037
DO  - 10.2196/29101
ID  - info:doi/10.2196/29101
ER  -