Telemedicine in heart failure during COVID-19: like it, love it or lose it


Advocate BroMenn Endowed Professor, Mennonite College of Nursing, Illinois State University


The onset of Coronavirus disease 2019 (COVID-19) led to social distancing and stay-at-home recommendations to slow a surge in cases. Many hospitals and ambulatory medical services abruptly halted usual care services to participate in social distancing and prepare for intensive care admissions. Slowing of office services meant that providers of patients with chronic heart failure (HF) needed to find new ways to communicate with and manage patients since up to 90% of patients have symptoms, and at any time, over 30% have New York Heart Association functional class III or IV symptoms.1 Regardless if patients’ left ventricular ejection fraction reflects reduced or preserved etiologies or if the current status is decompensated or compensated, it is customary to maintain close follow-up.

It seems like a natural phenomenon that an unintended positive consequence of COVID-19 environmental changes would be to maintain interactions with patients using non-invasive distance health methods. Before COVID-19 became prominent, clinicians and investigators were using and examining telemedicine strategies to better meet patients in their communities. For example, telemedicine has been used to detect medication nonadherence and to facilitate self-care lifestyle modifications and clinical decisions. Although innovations in telemedicine have been ongoing, use was primarily an adjunct to office visits until the Centers for Medicare & Medicaid Services broadened access to telehealth services for Medicare beneficiaries on an emergency and temporary basis, as part of the COVID-19 Preparedness and Response Supplemental Appropriations Act. The enhanced coverage involves real-time interactive 2-way telecommunications that can be audio or video.

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