ACC23 3 pager.pdf
Hospital readmissions are a common and costly occurrence in patients with cardiovascular disease.
1 in 4
Heart failure patients are readmitted
within 30 days of discharge
$16,000
Average cost of a
cardiovascular-related readmission
42%
of Medicare beneficiaries have
at least 1 heart condition
Research Question
Could a virtual cardiovascular care program reduce the all-cause & cardiac readmission rates for patients with cardiovascular disease (CVD)?
Study Design
Between February 2021 and May 2022, Heartbeat Health, a digital health company, conducted an open-label prospective randomized study evaluating a virtual care program focused on reducing hospital readmissions in the 3-month post-discharge period.
Patients continued visits with traditional, ambulatory cardiologists during a virtual care program. Control patients received standard-of-care outpatient follow-up alone during the study period.
Initial outreach and onboarding for recently admitted patients with known CVD
!
HBH televisit with care team in post-discharge setting
!
Inclusion Criteria
- Recent hospital discharge
- Age ≥ 18 and < 89 years
- Established clinical care relationship with outpatient cardiologists
- Clinical management per HBH in conjunction with usual cardiology care
- Enrolled and onboarded within 30 days after discharge
- Additional televisits as clinically indicated for 3-month period
!
Exclusion Criteria
- Unable or unwilling to consent to treatment
- Living in a rehabilitation or long-term care facility
- Lack of a smartphone
- Not fluent in English
- Receiving palliative care
- In-hospice care
!
95 Heartbeat patients in discharge telemedicine program.
95 control patients identified through propensity score matching.
!
90 day cardiac and all-cause readmission risk was primary.
Baseline Characteristics
| INTERVENTION(N=95) | CONTROL(N=95) | |
|---|---|---|
| Age(in years) | 68.6(11.1) | 69.6(12.1) |
| Gender(Female) | 43(45.3) | 42(44.2) |
| HFpEF | 31(32.6) | 36(37.9) |
| HFrEF | 30(31.2) | 21(22.1) |
| HTN | 77(81.1) | 86(90.5) |
| CAD | 56(58.9) | 56(58.9) |
| Diabetes | 38(40.0) | 38(40.0) |
| CKD | 24(25.3) | 24(25.3) |
| All Cause 90 Day Readmission | 15(15.8) | 27(28.4) |
| Cardiac 90 Day Readmission | 8(8.4) | 17(17.9) |
| Medication changes | 4.1(3.8) | N/A |
| Number of televisits | 10.3(1.8) | N/A |
!
We demonstrate that a virtual care management program can effectively reduce readmission risk in patients with cardiovascular disease. Patients with high-frequency telemedicine visits had 90-day improvement in functional status, blood pressure control, and patient education.