Abstract
Background: The 2019 novel coronavirus disease (COVID-19) pandemic puts cardiology patients at high risk for worsening of their underlying disease due to a decrease in non-emergent outpatient visits and social distancing concerns. Our aim was to assess the impact of telemedicine on ambulatory cardiology. Our hypothesis was that telemedicine would bridge the drop in ambulatory visits thus allowing surveillance visits to continue. Methods: Retrospective study from 3/2 to 6/12/2020 utilizing an administrative ambulatory database. Weekly telemedicine and in-person visits were extracted from EMR schedules. A telemedicine orientation session and individualized in-service sessions were provided to all cardiology staff by an expert in telemedicine. Logistics of scheduling, consenting, conducting the visit, documenting and billing were reviewed. To maximize physical distancing, in-person visits were relocated to regional outpatient centers. Prior to COVID-19, 37 cardiologists and 2 nurse practitioners conducted an average of 350 ambulatory visits/week. Results: The number of providers conducting telemedicine visits increased from 3 (8%) pre-COVID-19 to 31 (79%) during the pandemic. Compared to pre-COVID average, the median (IQR) weekly total ambulatory visits during the pandemic was 62% (57-90%). During the COVID-19 pandemic, the median frequency of telemedicine visits was 18% (11-32%). (Figure 1) Conclusion: Ambulatory in-person cardiology visits decreased during the COVID-19 pandemic; however telemedicine visits partially compensated for this drop. At the height of stay-at-home orders, cardiology in-person outpatient visits decreased to 25%, but rapidly increased back up to 88% the usual in-person visit volume. Future study is needed to assess the impact on patient outcomes, family satisfaction, cost-effectiveness and revenue of telemedicine visits during the COVID-19 pandemic.
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