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Bart NK, Emmanuel S, Friits-Lamora R, Larkins E, Kotlyar E, Muthiah K, Jabbour A, Hayward C, Jansz PC, Keogh AM, Thomas E, Macdonald PS. Rapid triage and transition to telehealth for heart transplant patients in the COVID-19 pandemic setting. J Telemed Telecare 2023:1357633X231151714. [PMID: 36793232 PMCID: PMC9936174 DOI: 10.1177/1357633x231151714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/30/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND In the setting of the COVID-19 pandemic, a rapid uptake of telehealth services was instituted with the aim of reducing the spread of disease to vulnerable patient populations including heart transplant recipients. METHODS Single-center, cohort study of all heart transplant patients seen by our institution's transplant program during the first 6 weeks of transition from in-person consultation to telehealth (23 March - 5 June 2020). RESULTS Face-to-face consultation allocation strongly favored patients in the early post-operative period (34 vs. 242 weeks post-transplant; p < 0.001). Telehealth consultation dramatically reduced patient travel and wait times (80 min per visit saved in telehealth patients). No apparent excess re-hospitalization or mortality was seen in telehealth patients. CONCLUSIONS With appropriate triage, telehealth was feasible in heart transplant recipients, with videoconferencing being the preferred modality. Patients seen face-to-face were those triaged to be higher acuity based on time since transplant and overall clinical status. These patients have the expected higher rates of hospital re-admission, and therefore should continue to be seen in person.
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Affiliation(s)
- Nicole K Bart
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of Notre Dame, Notre Dame, USA
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Sam Emmanuel
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of Notre Dame, Notre Dame, USA
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Rodrigo Friits-Lamora
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Emily Larkins
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Eugene Kotlyar
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of Notre Dame, Notre Dame, USA
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Kavitha Muthiah
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Andrew Jabbour
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Christopher Hayward
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Paul C Jansz
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Anne M Keogh
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Emma Thomas
- Centre for Health Sciences Research, Faculty of Medicine, University of Queensland, Saint Lucia, Queensland, Australia
| | - Peter S Macdonald
- Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- School of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
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