Public health

Telehealth enables increase in cardiology outpatient consults

A Melbourne hospital saw more cardiology outpatients during the initial COVID-19 2020 lockdown than in previous years, with minimal adverse events, thanks to telemedicine, a new study has shown.

The study — published in the Internal Medicine Journal — found St Vincent’s Outpatient Cardiology Clinics’ consultations increased 22% year on year between March and August 2020.

The increase might be explained by improved patient attendance with COVID-19 telemedicine arrangements negating travel requirements, or from increased capacity due to reduced physical examinations shortened appointments, the study authors said.

Telemedicine accounted for 1754 of 2169 appointments conducted within the study period, with 1188 patients attending via telephone, and 327, via video consult.

“Overall, cardiac mortality in this cohort was low (0.3%)”, with three of five cases being ‘expected deaths’.

No differences in mortality or ED presentations were observed between telemedicine modalities, the study authors said.

Patients accessing telephone appointments were typically older, female, living in metropolitan areas, non-native English speakers and attending review appointments. They were also less likely to have further follow-up appointments in the study period than those using video calls.

Patients who had follow-up appointments often transitioned from telephone to face-to-face appointments or video call to telephone — likely as a matter of preference, infrastructure and confidence with particular technologies.

Cardiologists may also have been a “driving factor in encouraging face-to-face review if they [had] clinical concerns regarding a patient”, the study authors said.

Face-to-face appointments only accounted for 10% of all encounters during the study period.

The study authors concluded that the switch to telehealth during the COVID-19 pandemic enabled the cardiology department to maintain consultation volumes with very low levels of cardiac mortality and emergency department usage.

“Beyond COVID-19, telemedicine is a growing platform which has an important role of facilitating adequate access to healthcare for diverse patient groups,” they said.

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