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infectious diseaseCoronavirus/COVID19Optimizing the Potential for Telehealth in Cardiovascular Care (in the Era of...

Optimizing the Potential for Telehealth in Cardiovascular Care (in the Era of COVID-19): Time Will Tell

The coronavirus disease 2019 (COVID-19) pandemic has impacted global economies and brought about unprecedented challenges to health care systems. Much of the morbidity and mortality of the pandemic has been borne by those with underlying medical conditions, including cardiovascular disease., Efforts to limit the spread of this viral illness, particularly within vulnerable populations through social distancing, resulted in rapid conversion from office-based visits to virtual visits. This transition also accelerated the adoption of telehealth services in the outpatient management of cardiovascular disease.

Before the COVID-19 pandemic, use of telehealth services had been limited in cardiovascular care. Reasons for this included lack of infrastructure, restrictions placed by insurance and government agencies, and limited reimbursement. Remote monitoring of vital signs and cardiac rhythm transmissions from mobile health devices had been modestly employed. Although these modalities did improve access for patients, infrastructural redesign was needed.

Established Platforms and Modalities Before COVID-19

Although used interchangeably, the terms “telehealth” and “telemedicine” should be distinguished. Telehealth is a broad, all-encompassing term that leverages the use of telecommunication services for the education, monitoring, and treatment of individuals. Telemedicine is a subset of telehealth that involves a clinician or health care professional using these telecommunication services to provide a more direct health service to patients. There are several methods for providing telehealth care. The 2 main categories under which telehealth services typically fall are direct-to-patient and clinician-to-clinician platforms. Direct-to-patient platforms include audiovisual telemedicine visits and may include remote patient monitoring. Remote patient monitoring (such as electrocardiogram [ECG] strips from a patient’s Apple Watch) may be used during a telemedicine visit (synchronous) or between in-person visits (asynchronous).

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This article originally appeared in the November 2020 issue of The American Journal of Medicine.

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