Benefits of Telemedicine for Cardiology
28 Mar 2022
Dr. Ivan-Asen Shishmanov is an internationally recognized cardiologist practicing at the University Hospital “N. I. Pirogov”. He is part of the team of doctors-innovators who formed the Medical Advisory Board of Medrec:M. In this article, he shares the benefits of digital healthcare, and telemedicine in particular, for cardiology.
According to the World Health Organization, 17.9 million people lose their lives to cardiovascular problems each year. The most common of them are heart attack, stroke, and heart failure. Risk factors leading to these conditions are high blood pressure, lack of physical activity, smoking, obesity, high cholesterol. Unfortunately, some factors cannot be controlled such as family predisposition or age - for men aged 45 and over, and for women over 55.
This information shows that the modernization of cardiology and the implementation of innovative solutions for the treatment of cardiovascular diseases should be a priority in healthcare.
How does telemedicine help?
A key module of digital healthcare is telemedicine, due to its many benefits for both clinicians and patients. It provides timely and immediate access to health services through digital devices - computers, smartphones, tablets. Thanks to a variety of features such as chat, phone calls, or, more often, video calls, the doctors can perform many of their usual tasks such as issuing or renewing a prescription, conducting a follow-up consultation, assessing whether the patient needs physical examination, diagnose a disease or monitor the implementation of specific treatment.
For which cases is digital care appropriate?
Data from several studies on the benefits of telemedicine show that telemedicine is practicable, even in cases involving serious medical conditions. One such study - a meta-analysis from 2017 synthesizes the findings of 39 different studies conducted in China that are related to the use of telemedicine in the monitoring and treatment of heart failure. They present significant benefits for patients followed up by telemedicine:
- lower frequency of hospitalization
- shorter hospital stays
- lower mortality
Telemedicine provides an extremely convenient solution for monitoring the condition of patients with chronic cardiovascular disease. Globally, telemedicine is particularly often implemented in geographical areas where patients have difficult access to medical care - long distances, a small number of hospitals, etc.
Which diseases are monitored most often?
In Italy, for example, telemedicine projects have been running since 1990. The most common of these include remote monitoring of people with chronic cardiovascular disease, as well as counseling for specific cardiovascular events. In particular, the main applications include telemonitoring of patients with:
- chronic heart failure
- hypertension
- implanted devices such as a pacemaker, ICD (implantable defibrillator), CRT (cardio resynchronization therapy)
Digital health and heart devices
In recent years, more and more cardiac devices (pacemakers, ICD, CRT) have been used in cardiology, which has led to an increasing need for follow-up visits to patients with implanted devices. Remote monitoring of such devices has proven to be a very real alternative to intermittent visits. This allows early identification of possible problems with the device, as well as changes in the patient’s heart rate. The data is transmitted from the patient to the hospital where the intervention was performed via a mobile connection. Based on the received data, the attending physician decides whether it is necessary to reprogram the device, hospitalize the patient or change the therapy.
Congestive heart failure (CHF)
A clinical study of patients hospitalized for worsening heart failure used telemedicine to track patients. This model of work involved the use of portable ECG devices connected via mobile connection to CHF treatment centers. Patients, of course, did not work alone with the complex equipment. But instead of visiting a remote hospital, it was enough to visit a local health service, where they were examined and their data was transferred to the treatment center. After one year of follow-ups, patients observed this way showed a 12% absolute reduction in re-hospitalizations for HF compared to those observed the standard way - with on-site examinations.
Hypertension and telemedicine
Monitoring blood pressure at home plays a key role in the treatment of hypertension. Here, the tracking model is far simpler and more applicable. Virtually every patient with hypertension already has a blood pressure monitor. By simply keeping a diary and sharing the patient’s BP values with the attending physician, decisions are made about the therapy needed. In this case, it is often much easier and more convenient for both the doctor and the patient when it is possible to carry it out remotely.
Benefits for patients
In addition to the obvious benefit to the patients from telemedicine, in cases where patients do not have direct access to qualified health providers near their residence, there are several additional benefits, including:
- Lower price - often telemedicine examinations are cheaper than physical ones
- Improved access to health care - especially for people with limited mobility, in remote geographical areas, etc.
- Preventive care - again, the benefits here are mainly for people who have difficulty accessing health care. A survey from 2012 of patients with ischemic heart disease indicates that the preventive function of telemedicine has led to more favorable results for patients.
- Limiting the risk of infection
- Convenience
Digitalization in cardiology
In cardiology, models of digital healthcare practices have demonstrated benefits in terms of better tracking, prevention of changes in the patient’s clinic, stimulation of self-tracking, and patient health care. On the other hand, it also improves the quality of life and reduces the frequency of re-hospitalizations.
Telemedicine provides affordable health care for patients, especially those who have difficulty attending a physical examination with their doctor. In addition, it can be very useful in tracking chronic diseases through more frequent but more convenient virtual visits for both parties. By examining the medical records and data of the patient before the consultation, clinicians are better prepared for their time with each patient.
Have you ever tried a virtual consultation with a doctor? Try the Medrec:M mobile app and find out how it works here.
Author: Dr. Ivan-Asen Shishmanov, cardiologist