Virtual Care Delivery Visits
We considered many things when creating our telemedicine solution. The most important was preserving and reaffirming the doctor-patient relationship. This special bond which allows open communication and sharing of the most personal concerns is critical to who we are as healthcare providers and we worked diligently to preserve it. Using real-time, audio-video communication tools we are now able to truly connect with our patients directly.
As a process-driven practice, CHFCare Cardiology uses a three-part virtual care visit (VCV) approach which assures all your needs are met. Our goal is virtual care delivery and not just having a conversation.
What to Expect During Your Virtual Visit
- Pre-visit -this is where your CHFCare Team’s medical assistant (MA) makes sure all your labs, diagnostic images, and medical records are available and ready for review. The MA is well-trained and makes sure all the technical components are all working-both on your end and ours. During the pre-visit your CHFCare Doctor or NP will review all records.
- Virtual visit-At the time of your appointment, your CHFCare provider will come on. Although it will seem to you to be a pleasant back and forth conversation, your provider is actually following a specific process designed to comprehensively obtain all needed information and perform all needed assessments to formulate a treatment plan without making you feel rushed or under interrogation.
- Post-visit -The final part of the virtual care visit (VCV) is the post-visit which starts immediately after you’re finished with your CHFCare provider. At this time your MA will review the messages, notes, and orders from the session. She will make sure everything has been sent out to labs, radiology, pharmacy, and your referring doctor’s office. You will get a secure message letting you know all this has been done and the next steps in your care.
Virtual Cardiology Consultation (VCC)
As experts in heart failure management and program development, CHFCare providers are available for consultations to other physicians. We can connect real-time to have doctor to doctor conversations about a patient (synchronous) or we can provide off-line consultations (asynchronous) after careful review of medical records, relevant diagnostic images and lab data. We are always happy to provide a second opinion. As heart failure specialists we work with both primary care physicians as well as other cardiologists to make sure every patient receives the best care possible.
Remote Patient Monitoring (RPM)
Our Virtual Heart Center was actually designed to be a central location for receiving and responding to the huge amount of information coming from our heart failure patients with implanted devices. We have expanded it to a Center for integrating remote monitoring information from home-based consumer systems for blood pressure, daily weights, heart rhythm monitors, and other home-monitoring information.
An experienced CHFCare provider is specifically assigned 24/7 to be responsible for managing the virtual heart center and quickly respond to patients, visiting nurses, primary care, and third-party monitoring stations.
Virtual Check Ups (VCUs)
VCUs are brief phone calls, patient portal ticklers, or secure messaging contacts we make between visits to check on heart failure patients we are a little more worried about. We also use these virtual checkups to follow up on results of medication changes and to see if ordered labs and imaging tests have been done. Our VCUs are a two-way street and patients can call or tickle their CHFCare provider for any health concerns which can’t wait for the next visit.
Virtual Acute Care (VACs)
We always knew our patients were at risk and every year we make sure they get their flu shots. The COVID-19 attacks have been more devastating to heart failure patients than expected. In response we created an extension of our virtual care visits to take care of patients with heart disease with worsening symptoms while sheltered in place. Our virtual acute care (VAC) program works by increasing the intensity of care for patients with worsening symptoms by placing them on advanced remote monitoring system with continuous vital signs, heart rhythm, and lung water assessment. We make adjustments to their medical regimen based on the daily video rounds, telemetry information, and in conjunction with nursing assessments just as we would do in the hospital. We follow the patient on daily video rounds with face to face visits as needed. Most patients turn around after 4-5 days and can then be “discharged” from virtual acute care back to their regular monitoring and routine visits.
VAC@SNF Program Development
We are currently evaluating whether our virtual acute care system can help skilled nursing facilities avoid hospital ED transfers for symptomatic heart failure patients. Treatment at the facility would avoid exposing these vulnerable patients to infections in the ED or hospital ward. The virtual acute care system can also be deployed at SNFs to more closely monitor recent hospital discharges to be certain their heart failure has been well-treated.
