Abstract 14707: Telehealth Usage for Outpatient Cardiology Evaluations During the COVID-19 Pandemic

Abstract

Introduction: The use of telehealth for cardiac services rapidly expanded during the pandemic, but little is known about the factors driving use of telehealth versus traditional in-person outpatient evaluation. Research Question: What factors are associated with telehealth use for patients with symptoms of cardiovascular disease referred for outpatient cardiology evaluation during the COVID-19 pandemic? Methods: In a large, integrated healthcare system caring for >4.5M patients, we identified those aged >18 years without prior cardiology diagnoses or visits who were evaluated for symptoms of incident heart failure, coronary disease, or arrhythmias before (Jan 2018-Dec 2019) and during the pandemic (June 2020-May 2022) periods. We categorized patients based on initial cardiology visit type: telehealth (video or telephone) or in-person. We compared unadjusted demographic, socioeconomic (SES), and clinical characteristics between visit types, and examined multivariable associations using Cox regression. Results: Only 146 (2.2%) of 6376 pre-pandemic patients versus 4074 (69%; 1213 telephone, 2861 video) of 5898 pandemic patients had an initial cardiology telehealth visit. In the pandemic period, compared to those with in-person visits, patients with video visits were more likely to be younger (58 vs 64 yrs; p<0.01), female (49% vs 45%; p<0.01), and to be linked to a facility with parking fees (11% vs 7%; p<0.01). Telephone visits had the highest proportion of patients with low SES, low internet usage, and a higher comorbidity burden. In adjusted models, these relationships were generally upheld ( Figure ), and the later year of the pandemic (2022) were strongly associated with increased in-person visits. Conclusions: Many patient and system level factors were associated with telehealth use during the COVID-19 pandemic. Future studies should examine the relationship between clinical outcomes and visit type, as telehealth has become part of routine care.