LETTER


Feasibility of Telephone-Based Cardiology Consultation: Comparison of Resource Use and Outcomes vs In-Person Consultation



Martin E. Matsumura1, *, Kelly Austin1, Yasser Khalil1, James C. Blankenship1, Bryan Martin1
1 Pearsall Heart Hospital, Geisinger Health System, Wilkes-Barre PA, United States


© 2021 Matsumura et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Pearsall Heart Hospital, Geisinger Health System, Wilkes-Barre PA, United States; Tel: (570) 808-6020;
Fax: (570) 808-5360; E-mail: mmatsumura@geisinger.edu


Abstract

Introduction:

The COVID-19 (Coronavirus infectious disease 2019) pandemic has highlighted the need for alternative modalities to connect with outpatients beyond in-person clinic visits. In the present study, we evaluated the feasibility of a telephone-based teleconsultation cardiology service and compared the use of testing and outcomes between teleconsultation and traditional in-office consultations

Methods:

The study took place prior to the COVID-19 pandemic July 2019 to March 2020. Consult lists were reviewed by a cardiologist for patients appropriate for teleconsultation. Those patients were contacted directly and, if agreeable, a consultation was completed and any required testing was arranged. A series of patients seen in the clinic, matched for a reason for consultation and consulting a cardiologist, were compared in terms of testing frequency and outcomes.

Results:

Of 157 patients who felt appropriate for teleconsultation, 100 (63.7%) were successfully contacted and a teleconsultation was completed. Comparing patients undergoing teleconsultation with a matched series of patients seen in person in the clinic, there were no significant differences in testing utilization or outcomes, including emergency room or hospital admission within 30 days of consultation or death or adverse cardiac events at six months following consultation.

Conclusion:

Telemedicine can be successfully utilized as an alternative to traditional clinic consultation for selected patients needing cardiology consultation. This consultative modality does not appear to lead to utilization of increased testing or decreased quality or patient outcomes. Larger studies are needed to assess this mode of consultation.

Keywords: Telecardiology, Telemedicine, Consultation, Pandemic, COVID-19, Cardiology.