A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic

Liane Stein; Hallie Rebecca Benjamin; Daniel Goldshtein; David Newman

doi:doi:10.11648/j.ccr.20220603.12

| Peer-Reviewed

A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic

Liane Stein, Hallie Rebecca Benjamin, Daniel Goldshtein, David Newman

Published in Cardiology and Cardiovascular Research (Volume 6, Issue 3)

Received: 8 September 2022 Accepted: 26 September 2022 Published: 11 October 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

To slow the spread of coronavirus-2019, many healthcare providers in Canada transitioned to tele-health in order to treat patients and minimize office visits. We investigated if the type of patient-physician encounter: in-person versus tele-health phone consultation, has an impact on cardiovascular outcome in an outpatient cardiac clinic in Toronto, Ontario. We conducted a comparative cohort study between patients seen in the office and patients who spoke to the physician by phone. Demographic data was collected on both groups regarding, age, symptoms, and cardiac diagnoses. Both sets of patients underwent physiological testing prior to meeting with the physician. Outcome measures included unplanned phone calls or visits, procedures, hospitalizations, and death. Results: 47 patients were seen in the office and 50 patients were seen via tele-health phone consultation. Patients were all non-selected sequential. Metrics of demographic data did not differ between groups regarding age, sex, symptoms (palpitations, dyspnea, syncope, chest pain), and diagnoses (arrythmia, coronary artery disease, devices, valve, heart failure, or cardiomyopathy. Odds ratio (OR) was calculated to compare outcome measures. Unplanned phone calls or visits (OR 1.61, CI 0.72, 3.61), procedures (OR 0.94, CI 0.13, 6.95), hospitalization (OR 0.93, CI 0.03, 2.89), and mortality (OR 0.46, CI 0.04, 5.25). We conclude that cardiovascular outcomes assessed did not differ by type of physician encounter. Both groups saw similar rates of physician intervention and changes to treatment plan. Further research into implications of tele-health on physician and patient satisfaction are needed.

Published in	Cardiology and Cardiovascular Research (Volume 6, Issue 3)
DOI	10.11648/j.ccr.20220603.12
Page(s)	86-91
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Tele-medicine, Cardiology, Cardiovascular, Arrythmia

References

[1]	Sohrabi C, Alsafi Z, O'neill N, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020; 76: 71-6.
[2]	Hollander JE, Carr BG. Virtually perfect? Telemedicine for COVID-19. N Engl J Med. 2020; 382: 1679-81.
[3]	Bosworth A, Ruhter J, Samson LW, Sheingold S, Taplin C, Tarazi W, Zuckerman R. Medicare beneficiary use of telehealth visits: early data from the start of COVID-19 pandemic. ASPE Issue Brief. 2020; 1-22.
[4]	Virani SA, Clarke B, Ducharme A, et al. Optimizing access to heart failure care in Canada during the COVID-19 pandemic. Can J Cardiol. 2020; 36: 1148-51.
[5]	Bhatia RS, Chu C, Pang A, Tadrous M, Stamenova V, Cram P. Virtual care use before and during the COVID-19 pandemic: a repeated cross-sectional study. J Can Med Assoc Open Access. 2021; 9: E107-14.
[6]	Gorodeski EZ, Goyal P, Cox ZL, et al. Virtual visits for care of patients with heart failure in the era of COVID-19: a statement from the Heart Failure Society of America. J Card Fail. 2020; 26: 448-56.
[7]	Koehler F, Koehler K, Deckwart O, el al. Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. The Lancet. 2018; 392: 1047-57.
[8]	Dansky KH, Vasey J, Bowles K. Impact of telehealth on clinical outcomes in patients with heart failure. Clin Nurs Res. 2008; 17: 182-99.
[9]	Ramaswamy A, Yu M, Drangsholt S, et al. Patient satisfaction with telemedicine during the COVID-19 pandemic: retrospective cohort study. J Med Internet Res. 2020; 22 (9): e20786.
[10]	Cho D, Khalil S, Kamath M, el al. Evaluating factors of greater patient satisfaction with outpatient cardiology telehealth visits during the COVID-19 pandemic. Cardiovasc Digit Health J. 2021; 2: 312-22.
[11]	TCPS 2. Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada. Tri-Council Policy Statement: ethical conduct for research involving humans. 2018.
[12]	Su D, Zhou J, Kelley MS, et al. Does telemedicine improve treatment outcomes for diabetes? A meta-analysis of results from 55 randomized controlled trials. Diabetes Res Clin Pract. 2016; 116: 136-48.
[13]	de Jong MJ, van der Meulen-de AE, Romberg-Camps MJ, el al. Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial. The Lancet. 2017; 390: 959-68.
[14]	Portnoy JM, Waller M, De Lurgio S, Dinakar C. Telemedicine is as effective as in-person visits for patients with asthma. Ann Allergy Asthma Immunol. 2016; 117: 241-5.
[15]	Bestsennyy O, Gilbert G, Harris A, Rost J. Telehealth: a quarter-trillion-dollar post-COVID-19 reality. McKinsey & Company. 2021; 22.
[16]	Kleiner, K. Ontario make virtuual care permanent: Physicians agree that virtual care needs to be balanced with in-persoon visits. Ont Med Rev, 2020; 3: 14-17.
[17]	Ontario Medical Associate; 2022 March 28. Press release, Ontario’s doctors ratify new three-year agreement with province. Available at: https://www.oma.org/newsroom/news/2022/march/ontarios-doctors-ratify-new-three-year-agreement-with-province/ Accessed on June 19, 2022.
[18]	Hardcastle L, Ogbogu U. Virtual care: Enhancing access or harming care? Healthc Manage Forum. 2020; 33: 288-292.
[19]	Miller EA. The technical and interpersonal aspects of telemedicine: effects on doctor–patient communication. J Telemed Telecare. 2003; 9 (1): 1-7.
[20]	Bauer KA. Home-based telemedicine: a survey of ethical issues. Camb Q Healthc Ethics. 2001; 10: 137-46.
[21]	McAlearney AS, Gaughan AA, Shiu-Yee K, DePuccio MJ. Silver Linings Around the Increased Use of Telehealth After the Emergence of COVID-19: Perspectives from Primary Care Physicians. J Prim Care Community Health. 2022; 13: 21501319221099485.

Cite This Article

Plain Text BibTeX RIS

APA Style

Liane Stein, Hallie Rebecca Benjamin, Daniel Goldshtein, David Newman. (2022). A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic. Cardiology and Cardiovascular Research, 6(3), 86-91. https://doi.org/10.11648/j.ccr.20220603.12

Copy | Download

ACS Style

Liane Stein; Hallie Rebecca Benjamin; Daniel Goldshtein; David Newman. A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic. Cardiol. Cardiovasc. Res. 2022, 6(3), 86-91. doi: 10.11648/j.ccr.20220603.12

Copy | Download

AMA Style

Liane Stein, Hallie Rebecca Benjamin, Daniel Goldshtein, David Newman. A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic. Cardiol Cardiovasc Res. 2022;6(3):86-91. doi: 10.11648/j.ccr.20220603.12

Copy | Download

@article{10.11648/j.ccr.20220603.12,
  author = {Liane Stein and Hallie Rebecca Benjamin and Daniel Goldshtein and David Newman},
  title = {A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic},
  journal = {Cardiology and Cardiovascular Research},
  volume = {6},
  number = {3},
  pages = {86-91},
  doi = {10.11648/j.ccr.20220603.12},
  url = {https://doi.org/10.11648/j.ccr.20220603.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20220603.12},
  abstract = {To slow the spread of coronavirus-2019, many healthcare providers in Canada transitioned to tele-health in order to treat patients and minimize office visits. We investigated if the type of patient-physician encounter: in-person versus tele-health phone consultation, has an impact on cardiovascular outcome in an outpatient cardiac clinic in Toronto, Ontario. We conducted a comparative cohort study between patients seen in the office and patients who spoke to the physician by phone. Demographic data was collected on both groups regarding, age, symptoms, and cardiac diagnoses. Both sets of patients underwent physiological testing prior to meeting with the physician. Outcome measures included unplanned phone calls or visits, procedures, hospitalizations, and death. Results: 47 patients were seen in the office and 50 patients were seen via tele-health phone consultation. Patients were all non-selected sequential. Metrics of demographic data did not differ between groups regarding age, sex, symptoms (palpitations, dyspnea, syncope, chest pain), and diagnoses (arrythmia, coronary artery disease, devices, valve, heart failure, or cardiomyopathy. Odds ratio (OR) was calculated to compare outcome measures. Unplanned phone calls or visits (OR 1.61, CI 0.72, 3.61), procedures (OR 0.94, CI 0.13, 6.95), hospitalization (OR 0.93, CI 0.03, 2.89), and mortality (OR 0.46, CI 0.04, 5.25). We conclude that cardiovascular outcomes assessed did not differ by type of physician encounter. Both groups saw similar rates of physician intervention and changes to treatment plan. Further research into implications of tele-health on physician and patient satisfaction are needed.},
 year = {2022}
}

Copy | Download

TY - JOUR
T1 - A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic
AU - Liane Stein
AU - Hallie Rebecca Benjamin
AU - Daniel Goldshtein
AU - David Newman
Y1 - 2022/10/11
PY - 2022
N1 - https://doi.org/10.11648/j.ccr.20220603.12
DO - 10.11648/j.ccr.20220603.12
T2 - Cardiology and Cardiovascular Research
JF - Cardiology and Cardiovascular Research
JO - Cardiology and Cardiovascular Research
SP - 86
EP - 91
PB - Science Publishing Group
SN - 2578-8914
UR - https://doi.org/10.11648/j.ccr.20220603.12
AB - To slow the spread of coronavirus-2019, many healthcare providers in Canada transitioned to tele-health in order to treat patients and minimize office visits. We investigated if the type of patient-physician encounter: in-person versus tele-health phone consultation, has an impact on cardiovascular outcome in an outpatient cardiac clinic in Toronto, Ontario. We conducted a comparative cohort study between patients seen in the office and patients who spoke to the physician by phone. Demographic data was collected on both groups regarding, age, symptoms, and cardiac diagnoses. Both sets of patients underwent physiological testing prior to meeting with the physician. Outcome measures included unplanned phone calls or visits, procedures, hospitalizations, and death. Results: 47 patients were seen in the office and 50 patients were seen via tele-health phone consultation. Patients were all non-selected sequential. Metrics of demographic data did not differ between groups regarding age, sex, symptoms (palpitations, dyspnea, syncope, chest pain), and diagnoses (arrythmia, coronary artery disease, devices, valve, heart failure, or cardiomyopathy. Odds ratio (OR) was calculated to compare outcome measures. Unplanned phone calls or visits (OR 1.61, CI 0.72, 3.61), procedures (OR 0.94, CI 0.13, 6.95), hospitalization (OR 0.93, CI 0.03, 2.89), and mortality (OR 0.46, CI 0.04, 5.25). We conclude that cardiovascular outcomes assessed did not differ by type of physician encounter. Both groups saw similar rates of physician intervention and changes to treatment plan. Further research into implications of tele-health on physician and patient satisfaction are needed.
VL - 6
IS - 3
ER -

Copy | Download

Author Information

Liane Stein

Faculty of Arts, McGill University, Montreal, Canada
Hallie Rebecca Benjamin

Faculty of Sciences, Queens University, Kingston, Canada
Daniel Goldshtein

Faculty of Medicine, Queens University, Kingston, Canada
David Newman

Department of Cardiology, Sunnybrook Hospital, Toronto, Canada

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Liane Stein, Hallie Rebecca Benjamin, Daniel Goldshtein, David Newman. (2022). A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic. Cardiology and Cardiovascular Research, 6(3), 86-91. https://doi.org/10.11648/j.ccr.20220603.12

Copy | Download

ACS Style

Liane Stein; Hallie Rebecca Benjamin; Daniel Goldshtein; David Newman. A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic. Cardiol. Cardiovasc. Res. 2022, 6(3), 86-91. doi: 10.11648/j.ccr.20220603.12

Copy | Download

AMA Style

Liane Stein, Hallie Rebecca Benjamin, Daniel Goldshtein, David Newman. A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic. Cardiol Cardiovasc Res. 2022;6(3):86-91. doi: 10.11648/j.ccr.20220603.12

Copy | Download

@article{10.11648/j.ccr.20220603.12,
  author = {Liane Stein and Hallie Rebecca Benjamin and Daniel Goldshtein and David Newman},
  title = {A Comparative Cohort Study of Cardiac Outcomes in Outpatients Cared for over the Telephone Versus in-Person During the COVID-19 Pandemic},
  journal = {Cardiology and Cardiovascular Research},
  volume = {6},
  number = {3},
  pages = {86-91},
  doi = {10.11648/j.ccr.20220603.12},
  url = {https://doi.org/10.11648/j.ccr.20220603.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20220603.12},
  abstract = {To slow the spread of coronavirus-2019, many healthcare providers in Canada transitioned to tele-health in order to treat patients and minimize office visits. We investigated if the type of patient-physician encounter: in-person versus tele-health phone consultation, has an impact on cardiovascular outcome in an outpatient cardiac clinic in Toronto, Ontario. We conducted a comparative cohort study between patients seen in the office and patients who spoke to the physician by phone. Demographic data was collected on both groups regarding, age, symptoms, and cardiac diagnoses. Both sets of patients underwent physiological testing prior to meeting with the physician. Outcome measures included unplanned phone calls or visits, procedures, hospitalizations, and death. Results: 47 patients were seen in the office and 50 patients were seen via tele-health phone consultation. Patients were all non-selected sequential. Metrics of demographic data did not differ between groups regarding age, sex, symptoms (palpitations, dyspnea, syncope, chest pain), and diagnoses (arrythmia, coronary artery disease, devices, valve, heart failure, or cardiomyopathy. Odds ratio (OR) was calculated to compare outcome measures. Unplanned phone calls or visits (OR 1.61, CI 0.72, 3.61), procedures (OR 0.94, CI 0.13, 6.95), hospitalization (OR 0.93, CI 0.03, 2.89), and mortality (OR 0.46, CI 0.04, 5.25). We conclude that cardiovascular outcomes assessed did not differ by type of physician encounter. Both groups saw similar rates of physician intervention and changes to treatment plan. Further research into implications of tele-health on physician and patient satisfaction are needed.},
 year = {2022}
}

Copy | Download