Acceptability and impact of Cardiac Outpatient teleconsultations during COVID-19 restricted service delivery

Generate PDF
Initiative Type
Service Improvement
Status
Sustained
Added
Last updated

Summary

COVID-19 has triggered a change in the delivery of cardiac outpatient services at Townsville University Hospital. It's resulted in the targeted offering of Teleconsultations to appropriately triaged patients to replace face-to-face consultations. These patients belong to demographic groups who have indicated their preference for this modality. Patients appreciated the convenience of  the change in service and the money and time saved by them. 

Key dates
Jan 2020
Jul 2021
Implementation sites
Townsville University Hospital
Partnerships
No

Aim

  1. To recognise the patient identified factors influencing suitability of Telephone consultations in Cardiac Outpatient Clinics.
  2. To demonstrate the effect of teleconsultations on cardiac outpatient service delivery, and consideration of this modality as an alternative to address long waitlists and to optimise care delivery.

Benefits

  • The implementation of these alternative service delivery modalities reduce waitlists and ensure resource efficiencies.
  • Teleconsultations to deliver cardiac outpatient services were received more positively by patients than face-to-face consultations.

Background

Cardiovascular disease results in significant morbidity and mortality in regional, rural and remote areas, contributed to by lack of accessibility to health services.  The COVID-19 pandemic necessitated a reduction in-person consulting, facilitating the opportunity to explore the utility of less frequently utilised modalities such as teleconsultations, which have the potential to improve service accessibility.

Solutions Implemented

The acceptability and utility of teleconsultations for cardiac outpatients has resulted in routine use of teleconsultations for appropriately triaged patients despite restrictions on in-person consultations due to COVID-19 being lifted.

Evaluation and Results

Part 1:   

  • Retrospective survey of patients who have engaged in a telephone consultation with cardiac clinics between April and June 2020 (n=1721) in lieu of a face-to-face appointment. A 5 percent response rate was achieved with respondent demographics comparable to overall cardiac outpatient clinic demographics.  

Part 2: 

  • Analysis of the routinely collected cardiac outpatient clinic data relating to number of consultations, type of consultations and waitlists between March and July 2020.

     

     

Lessons Learnt

  • Inability to access patient emails to disseminate requests for research involvement likely significantly impacts participation and response rates.
  • Access to and analysis of clinic and waitlist data is complex and nuanced and requires significant resourcing.

References

  1. WHO. A health telematics policy in support of WHO’s Health-For-All strategy for global health development: report of the WHO group consultation on health telematics; 1998  
  2. Cleland, J. G, Louis, A. A, Rigby, A. S, Janssens, U, Balk, A. H, & TEN-HMS Investigators. Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. Journal of the American College of Cardiology, 2005; 45(10), 1654–1664. https://doi.org/10.1016/j.jacc.2005.01.050 
  3. Koehler, F, Koehler, K, Deckwart, O, Prescher, S, Wegscheider, K, Kirwan, B. A, Winkler, S, Vettorazzi, E, Bruch, L, Oeff, M, Zugck, C, Doerr, G, Naegele, H, Störk, S, Butter, C, Sechtem, U, Angermann, C, Gola, G, Prondzinsky, R, Edelmann, F, Stangl, K.  Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. Lancet 2018; 392(10152), 1047–1057. https://doi.org/10.1016/S0140-6736(18)31880  
  4. Frederix I, Vanderlinden L, Verboven AS, et al. Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure. J Telemed Telecare. 2019;25(5):286‐293. doi:10.1177/1357633X18774632  
  5. Inglis SC, Clark RA, Dierckx  R, Prieto‐Merino  D, Cleland  JGF. Structured telephone support or non‐invasive telemonitoring for patients with heart failure. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD007228. DOI: 10.1002/14651858.CD007228.pub3.  
  6. Jin K, Khonsari S, Gallagher R, et al. Telehealth interventions for the secondary prevention of coronary heart disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2019;18(4):260‐271. doi:10.1177/1474515119826510 
  7. Brewer LC, Kaihoi B, Schaepe K, et al. Patient-perceived acceptability of a virtual world-based cardiac rehabilitation program. Digit Health. 2017;3:2055207617705548. Published 2017 Apr 24. doi:10.1177/2055207617705548 
  8. Boyde M, Rankin J, Whitty JA, et al. Patient preferences for the delivery of cardiac rehabilitation. Patient Educ Couns. 2018;101(12):2162‐2169. doi:10.1016/j.pec.2018.07.010 
  9. Woo K, Dowding D. Factors Affecting the Acceptance of Telehealth Services by Heart Failure Patients: An Integrative Review. Telemed J E Health. 2018;24(4):292‐300. doi:10.1089/tmj.2017.0080 
Share this

Key contact

Dr Rebecca Stewart
GP with Special Interest - Cardiology
Townsville University Hospital
07 44331111
rebecca.stewart@health.qld.gov.au

Related projects

Tele-Cardiac investigations for early diagnosis in rural Queensland

The Tele-Cardiac Investigations (T-CI) program involved cardiology staff, from the Royal Brisbane and Women’s...

Project tags