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Management and outcomes of chest pain telemedicine visits in a cardiology clinic during the COVID-19 pandemic

Management and outcomes of chest pain telemedicine visits in a cardiology clinic during the... Abstract Background Beginning in March 2020, the COVID-19 pandemic forced many outpatient chest pain evaluations to be performed via telemedicine. The purpose of this study was to examine the impact of telemedicine on management and outcomes of patients who presented with chest pain. Methods This retrospective chart review study included 771 unique patients, age >18 years, who were seen face-to-face in cardiology clinic visits from March 2019 through September 2019 with an encounter diagnosis of chest pain or angina, compared with 172 unique patients of age >18 who were seen via telehealth visit from March 2020 through September 2020. Data were extracted on patients’ clinical outcomes up to 1 year after the initial visit, including emergency department visit or hospital admission for chest pain, any hospital admission, additional diagnostic testing, revascularization, and death (cardiovascular or any). Results The telehealth group had higher rates of emergency department visits (19.2% vs 11.7%, P = 0.008), hospital admissions for chest pain (16.9% vs 10.5%, P = 0.019), as well as all hospital admissions (36.1% vs 28.2%, P = 0.04) compared with the face-to-face group. More patients in the face-to-face group received a stress test (41.1% vs 21.5% for the telehealth group; P < 0.001). There were no other statistically significant differences for diagnostic evaluations, revascularization, or death. Conclusion Our findings suggest that in-person evaluation for chest pain may aid in reducing the number of emergency department visits and hospital admissions when compared to telehealth evaluation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Baylor University Medical Center Proceedings Taylor & Francis

Management and outcomes of chest pain telemedicine visits in a cardiology clinic during the COVID-19 pandemic

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Management and outcomes of chest pain telemedicine visits in a cardiology clinic during the COVID-19 pandemic

Abstract

Abstract Background Beginning in March 2020, the COVID-19 pandemic forced many outpatient chest pain evaluations to be performed via telemedicine. The purpose of this study was to examine the impact of telemedicine on management and outcomes of patients who presented with chest pain. Methods This retrospective chart review study included 771 unique patients, age >18 years, who were seen face-to-face in cardiology clinic visits from March 2019 through September 2019 with an encounter...
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Publisher
Taylor & Francis
Copyright
Copyright © 2023 Baylor University Medical Center
ISSN
1525-3252
eISSN
0899-8280
DOI
10.1080/08998280.2023.2187205
Publisher site
See Article on Publisher Site

Abstract

Abstract Background Beginning in March 2020, the COVID-19 pandemic forced many outpatient chest pain evaluations to be performed via telemedicine. The purpose of this study was to examine the impact of telemedicine on management and outcomes of patients who presented with chest pain. Methods This retrospective chart review study included 771 unique patients, age >18 years, who were seen face-to-face in cardiology clinic visits from March 2019 through September 2019 with an encounter diagnosis of chest pain or angina, compared with 172 unique patients of age >18 who were seen via telehealth visit from March 2020 through September 2020. Data were extracted on patients’ clinical outcomes up to 1 year after the initial visit, including emergency department visit or hospital admission for chest pain, any hospital admission, additional diagnostic testing, revascularization, and death (cardiovascular or any). Results The telehealth group had higher rates of emergency department visits (19.2% vs 11.7%, P = 0.008), hospital admissions for chest pain (16.9% vs 10.5%, P = 0.019), as well as all hospital admissions (36.1% vs 28.2%, P = 0.04) compared with the face-to-face group. More patients in the face-to-face group received a stress test (41.1% vs 21.5% for the telehealth group; P < 0.001). There were no other statistically significant differences for diagnostic evaluations, revascularization, or death. Conclusion Our findings suggest that in-person evaluation for chest pain may aid in reducing the number of emergency department visits and hospital admissions when compared to telehealth evaluation.

Journal

Baylor University Medical Center Proceedings – Taylor & Francis

Published: May 4, 2023

Keywords: Chest pain; telehealth; telemedicine

References

  • Pattern and outcome of subsidised referrals to cardiology specialist outpatient clinics
  • Trends in the use of telehealth during the emergence of the COVID-19 pandemic—United States, January–March 2020
  • Outpatient management of heart failure during the COVID-19 pandemic after adoption of a telehealth model
  • Heart failure management during the COVID-19 outbreak in Italy: a telemedicine experience from a heart failure university tertiary referral centre
  • Deaths: leading causes for 2017
  • Episodes of care for chest pain: a preliminary report from MIRNET. Michigan Research Network
  • National Hospital Ambulatory Medical Care Survey: 2017 Emergency Department Summary Tables
  • Heart disease and stroke statistics—2011 update: a report from the American Heart Association
  • Patient perceptions of telehealth primary care video visits
  • DSHS announces first case of COVID-19 in Texas