Telemedicine and Cardiovascular Care: AHA Guidelines Point to Opportunities

The staggering costs of cardiovascular disease in the United States have been well documented; a 2015 CDC Foundation study, for example, estimated that one out of every six dollars spent on health care goes toward caring for the approximately 85 million patients with these conditions, as well as seven million stroke survivors. However, the use of telemedicine has gone a long way toward increasing access to quality, affordable care for this high-need patient population, and could continue to do so. In a new position paper published in the journal Circulation, the American Heart Association (AHA) highlights some of the benefits of utilizing telehealth technologies to care for these patients, while also offering some best practices for providers and pointing to implementation barriers that continue to pose a challenge.

Some of the specific benefits of telemedicine for cardiac care patients, per the AHA: reduced transportation costs to medical appointments, particularly for those residing in rural or other underserved areas; greater patient engagement in their own care; and an enhanced ability for different health care providers to communicate with one another about shared patients, which can be particularly useful for patients who see multiple different specialists.

The paper’s authors also highlight some of the characteristics of the most successful interventions for cardiovascular patients, including “timely transmission of data, receipt of the information by the appropriate staff who can analyze and act on it, a feedback loop to the patient with directions, and sufficient patient empowerment to understand and implement the instructions.” Not all interventions are created equal, but those that involve regular patient-provider communication and encourage patients to take control of their own care can go a long way toward improving clinical outcomes.

What are some of the barriers to wider implementation, and what can be done to begin addressing them? The AHA points to the difficult legal and regulatory landscape for telehealth technologies, including significant variation in reimbursement policies at the state level and the licensure-related challenges that come with treating patients across state lines. Further complicating matters: security and HIPAA compliance concerns, insufficient infrastructure in some of the areas where telehealth services are needed most, and (of course) costs.

But the report’s authors are optimistic about the increasing number of bipartisan telehealth-related bills that legislators have been introducing at the state and federal levels, many of which seek to address licensure issues and reimbursement, and some of which call for additional research. The AHA also wants to see CMS do more to encourage telemedicine, and calls for more collaboration among advocacy organizations to do the same. Taken together, these steps could ensure that telemedicine truly reaches its full potential for use among heart disease and stroke patients.

Click here for the position statement from American Heart Association.


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