Based on findings from an ACC survey published Aug. 6 in Digital Health regarding cardiologists' perceptions towards the use of telehealth, some proposed clinical workflow models may offer guidance on when to best use telemedicine visits, potential resources required and the feasibility of remote visits for a variety of clinical encounters.

A total of 481 ACC CardioSurve panelists received the cross-sectional, online, anonymous 25-item survey from April 2023 to May 2023; the response rate was 31% and most were White and male. Researchers collected information regarding participants' sex, race, years in practice, primary specialty, types of outpatient visits offered in person and through telemedicine encounters, payer mix, and whether telemedicine visits were used before, during and after the COVID-19 pandemic.

Of note, the distribution of participants across career stages was similar, with 30% being early career, 26% mid-career and 38% late-career. Additionally, the three most common specialty certifications of survey respondents were general cardiology (57%), interventional cardiology (29%) and electrophysiology (6%).

Survey results showed that 70% of respondents continue to offer telemedicine visits post pandemic. Early career and mid-career cardiologists are more likely than later career cardiologists to offer telehealth visits (odds ratio, 5.56 and 1.394, respectively).

Only 22% reported using telepresenters, and 72% of them believe this improves their efficiency compared to one in three who had not used a telepresenter considering it would be beneficial.

Looking at barriers to telehealth, the lack of reliable internet access is a challenge for outpatient visits, with 63% of respondents reporting this as an issue. One-third of respondents believed that the risk for malpractice increased when providing care remotely and no difference was seen across disease stage.

Jennifer Miao, MD, et al., developed three clinical workflow models to address these potential barriers to telemedicine, based on patient location (home-based or office-based), availability of digital health tools, and availability of telepresenters. These workflows focus on determining visit goals, most appropriate visit location and overcoming visit barriers.

"The proposed clinical workflow models in this study may offer additional guidance on triaging the appropriateness of telemedicine visits, potential resources required, and the feasibility of remote visits for a variety of clinical encounters within the spectrum of outpatient cardiovascular care," write the authors. They note that the integration of telemedicine "may help to address current and projected workforce shortages within cardiology."