Abstract
Introduction: The COVID-19 pandemic led to widespread adoption of telemedicine, which has persisted in healthcare delivery. We aimed to characterize telemedicine use in ambulatory cardiology clinics over 2 years following onset of the COVID-19 pandemic. Question: What diagnoses are associated with telemedicine use in cardiology appointments? Methods: In this retrospective cohort study, demographic and encounter data of all cardiology clinic and telemedicine visits in the University of California Los Angeles (UCLA) Health System from 3/16/2020 to 6/27/2022 were obtained. Encounters were included if they were conducted by physicians, complete with ICD-10 codes, and not missing demographic data. Mixed effects logistic regression was used to model the association of diagnosis class (based on ICD-10 codes) with whether encounter was scheduled as telemedicine, adjusting for age, sex, race, ethnicity, social vulnerability index, date, and zip code. Results: The analysis included 72,878 patients (49.8% women, age 61.5 ± 17.2 years, 57.2% white, 12.5% Hispanic, 82.6% with zip code in a UCLA Health service area) over 248,373 encounters. Each patient had a median of 2 encounters (range 1-82). Of all encounters, 27,894 (11.2%) were scheduled as telemedicine. Telemedicine was more likely used in management of chronic conditions, especially metabolic disorders (adjusted OR [aOR] 2.26, 95% CI 2.10-2.44) and cardiomyopathies (aOR 2.10, 95% CI 1.93-2.28), than for evaluation of undifferentiated signs/symptoms. Telemedicine was less likely used for general exam/screening (aOR 0.52, 95% CI 0.46-0.58) and heart transplant (aOR 0.51, 95% CI 0.50-0.64; Table ). Conclusion: In this study, the most established use case for telemedicine in cardiology was care of chronic cardiac diagnoses among non-transplant patients. Ongoing maintenance of chronic cardiovascular conditions through telemedicine may be a sustainable healthcare delivery model post COVID-19 pandemic.
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