“Doc, your patient is here,” said one of the clinical staff members.
We were closing up for the day when my patient arrived over an hour late. He moved slowly and leaned into his cane as if it would split at any moment, looking exhausted.
He sat down apologetically to explain the taxing journey that he had taken to get to the clinic that day—a half mile walk to the bus stop to catch the 106, only to hop off and onto the 44 and then the 52.
I looked down at the reason for the visit: “blood pressure check.”
That was seven years ago. When I think back to that moment, I realize I knew even then how unjust and illogical it was to put our patients in situations like that. It was the comfortable model we were accustomed to, one that a fee for service structure caters to, but there was clearly a better way. Now, several years into Heartbeat Health’s experience, it is evident that a Virtual-First approach is the exact solution that we needed all along.
So what exactly is Virtual-First cardiology and how is it helping healthcare providers avoid issues like my clinic patient faced? It is specialty cardiac care that leverages data, device connectivity and clinicians to deliver on-demand cardiovascular services. It’s data-driven care connected not to a location but to the patient, able to serve them just as effectively remotely as in person. These elements serve as the foundation for care delivery — rather than the face to face experience that anchors traditional healthcare settings.
At Heartbeat, our collective experience over the last several years proves that this model is an optimal fit for a very wide range of cardiovascular conditions. In the ‘healthiest’ of cardiac populations, those who have not yet developed cardiovascular disease but who are at moderate to high risk of it, Virtual-First care allows them to meet a cardiologist from the comfort of their home on their phone or at their computer. Patients get engaged, educated, and involved with preventative measures such as statin therapy and lifestyle changes that may add years to their lives.
For the sickest of cardiac patients, those who are leaving the hospital with advanced heart failure or who just had a heart attack, Virtual-First cardiology enables frequent virtual visits driven by AI-driven algorithms which identify the most pressing risks. That prioritization model is then complemented by daily remote monitoring and ongoing care milestones. Among our historical patient panel, we have already observed 70% and 33% reductions in cardiac and all-cause readmission, respectively, with this approach.
Given the barriers that some face, such as the need for translation services or access to a laptop or WiFi, there are concerns that Virtual-First care will exacerbate the digital divide. However, thanks to the rapid pace of technological growth, many of those obstacles to accessing virtual treatment are rapidly disappearing. Furthermore, modern telemedicine, when done correctly and intentionally, takes those issues into account and systematically improves access to treatment.
For example, Heartbeat offers platform-agnostic mobile access with translator services to extend the reach of Virtual-First care. For patients without easy access, we work closely with family members, nurses, and medical assistants who can facilitate virtual visits. And for patients that still struggle to connect with us, we embed in brick and mortar PCP offices and offer services via mobile devices and digital tablets. This allows patients to reap the benefit of a high impact health visit with coordinated care between their central physician and a specialist.
Our approach represents a massive upgrade in the patient experience away from outdated, time consuming, expensive, one-size-fits-all care to a model that is significantly more efficient, convenient, and personalized.
It would be inaccurate to say that Virtual-First care will replace all face to face care. As physicians, we know the value of placing a hand on someone’s calf, detecting a subtle drop in body temperature, and knowing that they have decompensated into a low output cardiogenic shock. Yet, not every patient or situation requires in person care — and those visits can be avoidably wasteful in time, effort, and cost. That’s why Virtual-First care is the perfect complement to face to face visits; it emphasizes low-cost, easy and early access options which cater to most cardiac patients.
Virtual-First care also prioritizes medical management first, now thematic in most ACC/AHA guidelines, rather than a procedure-first approach. It allows for early recognition of organ system failure as the result of a disease’s progression so that we can more proactively prioritize those who need escalation in care.
As a practicing Virtual-cardiologist at Heartbeat, almost every day I think back to that patient who struggled to take three buses to our clinic in Philadelphia just for a routine blood pressure check. I often wonder how things would have been different had that patient been in our Virtual-First care model today. The answer is clear, and it keeps me and our growing team motivated every day to evolve our company and our model so that it extends to the greatest number of people that can benefit from it.