Abstract 13414: Promoting Health Equity Using a Hybrid Virtual Cardiac Rehabilitation Program

Abstract

Background: Cardiac rehabilitation (CR) is an effective program for the secondary prevention of cardiovascular disease. Novel CR delivery methods are needed to increase access in an equitable and cost-effective manner. Herein, we present lessons learned in developing and implementing our hybrid CR program. Methods: We established a 5-step approach to increase engagement in CR using a hybrid in-center and virtual model: 1-Assemble a Team and Technology Platform Develop a team with diverse perspectives and integrate technology to facilitate patient participation. 2-Establish an Equitable Onboarding Process Combine patient navigators with video tutorials to support equitable access for patients at different levels of digital literacy. 3-Gather Feedback Conduct design sessions to elicit feedback. 4-Implement Feedback Use quality improvement (QI) protocols to iteratively improve onboarding and refine logistics. 5-Evaluate Clinical Efficacy Conduct studies to investigate the program's efficacy in improving outcomes. Results: In step 3, we used human centered design (HCD) to solicit feedback from patients, caregivers, and clinician stakeholders to influence the creation of our program. Our patient sample was 27% African American, 9% Asian, 18% Hispanic or Latino, 55% female, with a median (IQR) age of 63 (56-66) years. Feedback led to the creation of a video on CR benefits, the introduction of motivational coaches, and the creation of an EPIC order set. In step 4, using QI, we were successful in promoting equitable access as demonstrated by the fact that the patients had a mean age of 59.2 (SD: 10.4) years, 40% were female, 39% were of minority race/ethnicity, 58% were insured by Medicare/Medicaid. Conclusions: Our novel hybrid CR program shows promise for improving CR. Future directions (Step 5) include evaluation of the program in an mTECH REHAB Trial as part of AHA’s Strategic Focused Research Network.