Telehealth Works for CVD Care, But Challenges Ahead: AHA

Telehealth has become a proven and valuable way to deliver cardiovascular disease (CVD) care, but ongoing limitations, including access to technology, hinder widespread adoption, the American Heart Association (AHA) concludes in a new scientific statement.

"Telehealth utilization grew tremendously during the COVID-19 pandemic. This timely AHA scientific statement highlights strengths and limitations for telehealth, and it identifies areas for future research and innovation that will help to optimize the incorporation of telehealth into the future of clinical practice," writing group chair Edwin A. Takahashi, MD, Mayo Clinic College of Medicine, Rochester, Minnesota, told theheart.org | Medscape Cardiology.

The statement, "An Overview of Telehealth in the Management of Cardiovascular Disease," was published online November 14 in Circulation.

Convenient, Patient-Centered Care

Telehealth "collapses the barriers of time and distance," making it ideal for providing high-value, patient-centered care, the writing group notes.

The benefits of telehealth are especially important for adults with CVD, which disproportionally affects racial and ethnic minority groups of lower socioeconomic status, who often face barriers to care, they point out.

Clinical experience has shown that telehealth can facilitate the management of many CVDs, including arrhythmia detection, heart failure, hypertension, coronary artery disease, and myocardial infarction.

"Telehealth can be utilized in many different ways. While routine and nonurgent clinical visits are returning to [being held] in person, telehealth can still play an important role for expeditious diagnosis and remote care monitoring, especially in areas with limited healthcare access," Takahashi said.

Ongoing Challenges

The writing group notes, however, that several challenges may prevent more widespread use of telehealth in CVD.

For healthcare professionals, these challenges include acceptance and uptake of telehealth technology; inconsistent reimbursement and licensing policies; logistical challenges in scheduling and maintaining workflow; and lack of infrastructure to analyze data from remotely monitored devices.

Patients with CVD may also face challenges, including limited resources to access technology and devices for older adults and under-resourced populations; health literacy barriers, including cultural and language barriers that may prevent people from using digital platforms, consumer wearables, and other devices; and poor internet access.

"We hope clinicians will see the potential benefits as well as the barriers to telehealth adoption," Takahashi said.

"Furthermore, we want others to recognize that there is still work to be done on optimizing different telehealth modalities from the standpoint of policy and infrastructure so that it is effective, equitable, sustainable, and most importantly, beneficial to our patients," he added.

Toward Excellence in Telehealth

To bolster the AHA's commitment to excellence in telehealth care for CVD, the organization recently acquired the American Board of Telehealth (ABT), a national entity that establishes best practices and standards for telemedicine education.

Among the initiatives of the ABT/AHA:

• Ensure healthcare professionals are equipped to deliver optimal virtual care by offering high-quality telehealth education to help advance their skills.

• Launch an individual telehealth certification for healthcare professionals interested in demonstrating their commitment to virtual care.

• Drive science and discovery of the impact on evidence-based care on patient outcomes.

• Advocate for policies that ensure everyone should have access to telehealth services regardless of their geographic location, race or ethnicity, gender, sexual orientation, or socioeconomic status.

• Support patients with education about telehealth and the actions they can take to fully maximize their care experience.

The scientific statement was prepared by the volunteer writing group on behalf of the AHA Council on Cardiovascular Radiology and Intervention, the Council on Hypertension, the Council on the Kidney in Cardiovascular Disease, and the Stroke Council.

Circulation. Published online November 14, 2022. Abstract

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