Patient Use and Clinical Practice Patterns of Remote Cardiology Clinic Visits in the Era of COVID-19

The COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. To understand whether the transition to remote visits is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing. This cross-sec...

Full description

Saved in:
Bibliographic Details
Published inJAMA network open Vol. 4; no. 4; p. e214157
Main Authors Yuan, Neal, Pevnick, Joshua M, Botting, Patrick G, Elad, Yaron, Miller, Shaun J, Cheng, Susan, Ebinger, Joseph E
Format Journal Article
LanguageEnglish
Published United States American Medical Association 01.04.2021
Subjects
Aged
Aged, 80 and over
Ambulatory Care
Ambulatory Care Facilities
Cardiology
Cardiology - methods
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - therapy
Coronaviruses
COVID-19
Cross-Sectional Studies
Ethnic Groups
Female
Health Policy
Healthcare Disparities
Hispanic people
Humans
Insurance, Health
Male
Middle Aged
Online Only
Original Investigation
Pandemics
Patient Acceptance of Health Care
Patients
Practice Patterns, Physicians
SARS-CoV-2
Telemedicine
Telemedicine - methods
Online AccessGet full text

Cover

Abstract The COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. To understand whether the transition to remote visits is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing. This cross-sectional study used electronic health records data for all ambulatory cardiology visits at an urban, multisite health system in Los Angeles County, California, during 2 periods: April 1, 2019, to December 31, 2019 (pre-COVID) and April 1 to December 31, 2020 (COVID-era). Statistical analysis was performed from January to February 2021. In-person or remote ambulatory cardiology clinic visit at one of 31 during the pre-COVID period or COVID-era period. Comparison of patient characteristics and frequencies of medication ordering and cardiology-specific testing across 4 visit types (pre-COVID in-person (reference), COVID-era in-person, COVID-era video, COVID-era telephone). This study analyzed data from 87 182 pre-COVID in-person, 74 498 COVID-era in-person, 4720 COVID-era video, and 10 381 COVID-era telephone visits. Across visits, 79 572 patients were female (45.0%), 127 080 patients were non-Hispanic White (71.9%), and the mean (SD) age was 68.1 (17.0) years. Patients accessing COVID-era remote visits were more likely to be Asian, Black, or Hispanic individuals (24 934 pre-COVID in-person visits [28.6%] vs 19 742 COVID-era in-person visits [26.5%] vs 3633 COVID-era video visits [30.4%] vs 1435 COVID-era telephone visits [35.0%]; P < .001 for all comparisons), have private insurance (34 063 pre-COVID in-person visits [39.1%] vs 25 474 COVID-era in-person visits [34.2%] vs 2562 COVID-era video visits [54.3%] vs 4264 COVID-era telephone visits [41.1%]; P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone), and have cardiovascular comorbidities (eg, hypertension: 37 166 pre-COVID in-person visits [42.6%] vs 31 359 COVID-era in-person visits [42.1%] vs 2006 COVID-era video visits [42.5%] vs 5181 COVID-era telephone visits [49.9%]; P < .001 for COVID-era in-person vs telephone; and heart failure: 14 319 pre-COVID in-person visits [16.4%] vs 10 488 COVID-era in-person visits [14.1%] vs 1172 COVID-era video visits [24.8%] vs 2674 COVID-era telephone visits [25.8%]; P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone). After adjusting for patient and visit characteristics and in comparison with pre-COVID in-person visits, during video and telephone visits, clinicians had lower odds of ordering any medication (COVID-era in-person: odds ratio [OR], 0.62 [95% CI, 0.60-0.64], COVID-era video: OR, 0.22 [95% CI, 0.20-0.24]; COVID-era telephone: OR, 0.14 [95% CI, 0.13-0.15]) or tests, such as electrocardiograms (COVID-era in-person: OR, 0.60 [95% CI, 0.58-0.62]; COVID-era video: OR, 0.03 [95% CI, 0.02-0.04]; COVID-era telephone: OR, 0.02 [95% CI, 0.01-0.03]) or echocardiograms (COVID-era in-person: OR, 1.21 [95% CI, 1.18-1.24]; COVID-era video: OR, 0.47 [95% CI, 0.42-0.52]; COVID-era telephone: OR, 0.28 [95% CI, 0.25-0.31]). Patients who were Asian, Black, or Hispanic, had private insurance, and had at least one of several cardiovascular comorbidities used remote cardiovascular care more frequently in the COVID-era period. Clinician ordering of diagnostic testing and medications consistently decreased when comparing pre-COVID vs COVID-era and in-person vs remote visits. Further studies are needed to clarify whether these decreases represent a reduction in the overuse of tests and medications vs an underuse of indicated testing and prescribing.
AbstractList The COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. To understand whether the transition to remote visits is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing. This cross-sectional study used electronic health records data for all ambulatory cardiology visits at an urban, multisite health system in Los Angeles County, California, during 2 periods: April 1, 2019, to December 31, 2019 (pre-COVID) and April 1 to December 31, 2020 (COVID-era). Statistical analysis was performed from January to February 2021. In-person or remote ambulatory cardiology clinic visit at one of 31 during the pre-COVID period or COVID-era period. Comparison of patient characteristics and frequencies of medication ordering and cardiology-specific testing across 4 visit types (pre-COVID in-person (reference), COVID-era in-person, COVID-era video, COVID-era telephone). This study analyzed data from 87 182 pre-COVID in-person, 74 498 COVID-era in-person, 4720 COVID-era video, and 10 381 COVID-era telephone visits. Across visits, 79 572 patients were female (45.0%), 127 080 patients were non-Hispanic White (71.9%), and the mean (SD) age was 68.1 (17.0) years. Patients accessing COVID-era remote visits were more likely to be Asian, Black, or Hispanic individuals (24 934 pre-COVID in-person visits [28.6%] vs 19 742 COVID-era in-person visits [26.5%] vs 3633 COVID-era video visits [30.4%] vs 1435 COVID-era telephone visits [35.0%]; P < .001 for all comparisons), have private insurance (34 063 pre-COVID in-person visits [39.1%] vs 25 474 COVID-era in-person visits [34.2%] vs 2562 COVID-era video visits [54.3%] vs 4264 COVID-era telephone visits [41.1%]; P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone), and have cardiovascular comorbidities (eg, hypertension: 37 166 pre-COVID in-person visits [42.6%] vs 31 359 COVID-era in-person visits [42.1%] vs 2006 COVID-era video visits [42.5%] vs 5181 COVID-era telephone visits [49.9%]; P < .001 for COVID-era in-person vs telephone; and heart failure: 14 319 pre-COVID in-person visits [16.4%] vs 10 488 COVID-era in-person visits [14.1%] vs 1172 COVID-era video visits [24.8%] vs 2674 COVID-era telephone visits [25.8%]; P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone). After adjusting for patient and visit characteristics and in comparison with pre-COVID in-person visits, during video and telephone visits, clinicians had lower odds of ordering any medication (COVID-era in-person: odds ratio [OR], 0.62 [95% CI, 0.60-0.64], COVID-era video: OR, 0.22 [95% CI, 0.20-0.24]; COVID-era telephone: OR, 0.14 [95% CI, 0.13-0.15]) or tests, such as electrocardiograms (COVID-era in-person: OR, 0.60 [95% CI, 0.58-0.62]; COVID-era video: OR, 0.03 [95% CI, 0.02-0.04]; COVID-era telephone: OR, 0.02 [95% CI, 0.01-0.03]) or echocardiograms (COVID-era in-person: OR, 1.21 [95% CI, 1.18-1.24]; COVID-era video: OR, 0.47 [95% CI, 0.42-0.52]; COVID-era telephone: OR, 0.28 [95% CI, 0.25-0.31]). Patients who were Asian, Black, or Hispanic, had private insurance, and had at least one of several cardiovascular comorbidities used remote cardiovascular care more frequently in the COVID-era period. Clinician ordering of diagnostic testing and medications consistently decreased when comparing pre-COVID vs COVID-era and in-person vs remote visits. Further studies are needed to clarify whether these decreases represent a reduction in the overuse of tests and medications vs an underuse of indicated testing and prescribing.
This cross-sectional study examines ambulatory cardiology clinic visit data and whether the transition to remote visits during COVID-19 is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing.
Importance The COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. Objective To understand whether the transition to remote visits is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing. Design, Setting, and Participants This cross-sectional study used electronic health records data for all ambulatory cardiology visits at an urban, multisite health system in Los Angeles County, California, during 2 periods: April 1, 2019, to December 31, 2019 (pre-COVID) and April 1 to December 31, 2020 (COVID-era). Statistical analysis was performed from January to February 2021. Exposure In-person or remote ambulatory cardiology clinic visit at one of 31 during the pre-COVID period or COVID-era period. Main Outcomes and Measures Comparison of patient characteristics and frequencies of medication ordering and cardiology-specific testing across 4 visit types (pre-COVID in-person (reference), COVID-era in-person, COVID-era video, COVID-era telephone). Results This study analyzed data from 87 182 pre-COVID in-person, 74 498 COVID-era in-person, 4720 COVID-era video, and 10 381 COVID-era telephone visits. Across visits, 79 572 patients were female (45.0%), 127 080 patients were non-Hispanic White (71.9%), and the mean (SD) age was 68.1 (17.0) years. Patients accessing COVID-era remote visits were more likely to be Asian, Black, or Hispanic individuals (24 934 pre-COVID in-person visits [28.6%] vs 19 742 COVID-era in-person visits [26.5%] vs 3633 COVID-era video visits [30.4%] vs 1435 COVID-era telephone visits [35.0%];P < .001 for all comparisons), have private insurance (34 063 pre-COVID in-person visits [39.1%] vs 25 474 COVID-era in-person visits [34.2%] vs 2562 COVID-era video visits [54.3%] vs 4264 COVID-era telephone visits [41.1%];P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone), and have cardiovascular comorbidities (eg, hypertension: 37 166 pre-COVID in-person visits [42.6%] vs 31 359 COVID-era in-person visits [42.1%] vs 2006 COVID-era video visits [42.5%] vs 5181 COVID-era telephone visits [49.9%];P < .001 for COVID-era in-person vs telephone; and heart failure: 14 319 pre-COVID in-person visits [16.4%] vs 10 488 COVID-era in-person visits [14.1%] vs 1172 COVID-era video visits [24.8%] vs 2674 COVID-era telephone visits [25.8%];P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone). After adjusting for patient and visit characteristics and in comparison with pre-COVID in-person visits, during video and telephone visits, clinicians had lower odds of ordering any medication (COVID-era in-person: odds ratio [OR], 0.62 [95% CI, 0.60-0.64], COVID-era video: OR, 0.22 [95% CI, 0.20-0.24]; COVID-era telephone: OR, 0.14 [95% CI, 0.13-0.15]) or tests, such as electrocardiograms (COVID-era in-person: OR, 0.60 [95% CI, 0.58-0.62]; COVID-era video: OR, 0.03 [95% CI, 0.02-0.04]; COVID-era telephone: OR, 0.02 [95% CI, 0.01-0.03]) or echocardiograms (COVID-era in-person: OR, 1.21 [95% CI, 1.18-1.24]; COVID-era video: OR, 0.47 [95% CI, 0.42-0.52]; COVID-era telephone: OR, 0.28 [95% CI, 0.25-0.31]). Conclusions and Relevance Patients who were Asian, Black, or Hispanic, had private insurance, and had at least one of several cardiovascular comorbidities used remote cardiovascular care more frequently in the COVID-era period. Clinician ordering of diagnostic testing and medications consistently decreased when comparing pre-COVID vs COVID-era and in-person vs remote visits. Further studies are needed to clarify whether these decreases represent a reduction in the overuse of tests and medications vs an underuse of indicated testing and prescribing.
ImportanceThe COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. ObjectiveTo understand whether the transition to remote visits is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing. Design, Setting, and ParticipantsThis cross-sectional study used electronic health records data for all ambulatory cardiology visits at an urban, multisite health system in Los Angeles County, California, during 2 periods: April 1, 2019, to December 31, 2019 (pre-COVID) and April 1 to December 31, 2020 (COVID-era). Statistical analysis was performed from January to February 2021. ExposureIn-person or remote ambulatory cardiology clinic visit at one of 31 during the pre-COVID period or COVID-era period. Main Outcomes and MeasuresComparison of patient characteristics and frequencies of medication ordering and cardiology-specific testing across 4 visit types (pre-COVID in-person (reference), COVID-era in-person, COVID-era video, COVID-era telephone). ResultsThis study analyzed data from 87 182 pre-COVID in-person, 74 498 COVID-era in-person, 4720 COVID-era video, and 10 381 COVID-era telephone visits. Across visits, 79 572 patients were female (45.0%), 127 080 patients were non-Hispanic White (71.9%), and the mean (SD) age was 68.1 (17.0) years. Patients accessing COVID-era remote visits were more likely to be Asian, Black, or Hispanic individuals (24 934 pre-COVID in-person visits [28.6%] vs 19 742 COVID-era in-person visits [26.5%] vs 3633 COVID-era video visits [30.4%] vs 1435 COVID-era telephone visits [35.0%]; P < .001 for all comparisons), have private insurance (34 063 pre-COVID in-person visits [39.1%] vs 25 474 COVID-era in-person visits [34.2%] vs 2562 COVID-era video visits [54.3%] vs 4264 COVID-era telephone visits [41.1%]; P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone), and have cardiovascular comorbidities (eg, hypertension: 37 166 pre-COVID in-person visits [42.6%] vs 31 359 COVID-era in-person visits [42.1%] vs 2006 COVID-era video visits [42.5%] vs 5181 COVID-era telephone visits [49.9%]; P < .001 for COVID-era in-person vs telephone; and heart failure: 14 319 pre-COVID in-person visits [16.4%] vs 10 488 COVID-era in-person visits [14.1%] vs 1172 COVID-era video visits [24.8%] vs 2674 COVID-era telephone visits [25.8%]; P < .001 for COVID-era in-person vs video and COVID-era in-person vs telephone). After adjusting for patient and visit characteristics and in comparison with pre-COVID in-person visits, during video and telephone visits, clinicians had lower odds of ordering any medication (COVID-era in-person: odds ratio [OR], 0.62 [95% CI, 0.60-0.64], COVID-era video: OR, 0.22 [95% CI, 0.20-0.24]; COVID-era telephone: OR, 0.14 [95% CI, 0.13-0.15]) or tests, such as electrocardiograms (COVID-era in-person: OR, 0.60 [95% CI, 0.58-0.62]; COVID-era video: OR, 0.03 [95% CI, 0.02-0.04]; COVID-era telephone: OR, 0.02 [95% CI, 0.01-0.03]) or echocardiograms (COVID-era in-person: OR, 1.21 [95% CI, 1.18-1.24]; COVID-era video: OR, 0.47 [95% CI, 0.42-0.52]; COVID-era telephone: OR, 0.28 [95% CI, 0.25-0.31]). Conclusions and RelevancePatients who were Asian, Black, or Hispanic, had private insurance, and had at least one of several cardiovascular comorbidities used remote cardiovascular care more frequently in the COVID-era period. Clinician ordering of diagnostic testing and medications consistently decreased when comparing pre-COVID vs COVID-era and in-person vs remote visits. Further studies are needed to clarify whether these decreases represent a reduction in the overuse of tests and medications vs an underuse of indicated testing and prescribing.
Author Miller, Shaun J
Ebinger, Joseph E
Yuan, Neal
Pevnick, Joshua M
Cheng, Susan
Botting, Patrick G
Elad, Yaron
AuthorAffiliation 3 Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
1 Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
2 Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
AuthorAffiliation_xml – name: 3 Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
– name: 2 Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
– name: 1 Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
Author_xml – sequence: 1
  givenname: Neal
  surname: Yuan
  fullname: Yuan, Neal
  organization: Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
– sequence: 2
  givenname: Joshua M
  surname: Pevnick
  fullname: Pevnick, Joshua M
  organization: Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
– sequence: 3
  givenname: Patrick G
  surname: Botting
  fullname: Botting, Patrick G
  organization: Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
– sequence: 4
  givenname: Yaron
  surname: Elad
  fullname: Elad, Yaron
  organization: Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
– sequence: 5
  givenname: Shaun J
  surname: Miller
  fullname: Miller, Shaun J
  organization: Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
– sequence: 6
  givenname: Susan
  surname: Cheng
  fullname: Cheng, Susan
  organization: Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
– sequence: 7
  givenname: Joseph E
  surname: Ebinger
  fullname: Ebinger, Joseph E
  organization: Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33818619$$D View this record in MEDLINE/PubMed
BookMark eNpdkV1rFDEUhoNUbK39CxLxxptZ8zEzSW4EmVYtFFrE9jacmTnTZp1J1iSr9N-bpWupvUogz3nJe57X5MAHj4S842zFGeMf17CAx_wnxJ9hg34lmOCrmjfqBTkSjaorqVlz8OR-SE5SWjPGBOPStM0rciil5rrl5oiMV5Ad-kyvE1LwI-1m590AM72KMGQ3IC1ExugTDRP9jkvISDuIowtzuL3f8_TGJZcTdZ7mO6RnEXZ0d3lzflpx84a8nGBOeLI_j8n1l7Mf3bfq4vLreff5ooJasVyB5MhqhLo3k2Kt0L3uBwYSmJF1O_bYjwM3RqIY5NTXum1GOYECRDGCkr08Jp8ecjfbfsFxKL0izHYT3QLx3gZw9v8X7-7sbfhtNRNC8LYEfNgHxPBriynbxaUB57lsPGyTFQ3T2sgCF_T9M3QdttGXela0rdK1UYoXyjxQQwwpRZweP8OZ3em0z3TanU6701lm3z5t8zj5T578C5HGotg
CitedBy_id crossref_primary_10_1016_j_ahjo_2022_100210
crossref_primary_10_1053_j_gastro_2021_06_069
crossref_primary_10_2196_32403
crossref_primary_10_1097_MLR_0000000000001832
crossref_primary_10_1097_MLR_0000000000001833
crossref_primary_10_1371_journal_pone_0282081
crossref_primary_10_3389_fpubh_2022_893871
crossref_primary_10_1016_j_cardfail_2023_05_004
crossref_primary_10_1016_j_cjca_2022_11_014
crossref_primary_10_1177_1357633X211073428
crossref_primary_10_1007_s43032_022_00877_3
crossref_primary_10_1111_jep_13896
crossref_primary_10_1177_00222429231207830
crossref_primary_10_5334_gh_1077
crossref_primary_10_1016_j_amjcard_2022_10_043
crossref_primary_10_1016_j_cvdhj_2021_10_005
crossref_primary_10_1371_journal_pone_0269435
crossref_primary_10_1111_ecc_13733
crossref_primary_10_1089_tmr_2021_0040
crossref_primary_10_3390_ijerph19116930
crossref_primary_10_1007_s11906_022_01169_6
crossref_primary_10_3390_healthcare11111590
crossref_primary_10_1007_s11897_023_00606_0
crossref_primary_10_1016_j_ijcard_2022_07_020
crossref_primary_10_1080_20477724_2022_2106110
crossref_primary_10_1007_s11606_023_08475_y
crossref_primary_10_1007_s40618_022_01814_6
crossref_primary_10_5435_JAAOS_D_22_00456
crossref_primary_10_1016_j_jaip_2022_02_027
crossref_primary_10_1016_j_ejim_2022_11_029
crossref_primary_10_1016_j_cardfail_2022_02_016
crossref_primary_10_1093_ehjdh_ztab055
crossref_primary_10_1161_JAHA_122_027922
crossref_primary_10_1161_CIRCRESAHA_121_319876
crossref_primary_10_32895_UMP_MPR_6_4_7
crossref_primary_10_3390_diagnostics12040972
crossref_primary_10_1097_HPC_0000000000000292
crossref_primary_10_1097_MOP_0000000000001159
crossref_primary_10_1016_j_cjco_2021_08_015
crossref_primary_10_1016_j_jacadv_2022_100156
crossref_primary_10_1177_1357633X241232464
crossref_primary_10_1007_s11886_021_01618_9
crossref_primary_10_1371_journal_pone_0267218
crossref_primary_10_1089_whr_2022_0066
crossref_primary_10_2196_41548
crossref_primary_10_1007_s11524_023_00744_9
crossref_primary_10_1161_CIR_0000000000001107
crossref_primary_10_1089_tmj_2023_0708
crossref_primary_10_3389_fcvm_2022_981023
crossref_primary_10_2196_29959
crossref_primary_10_3390_healthcare11121727
crossref_primary_10_1097_JOM_0000000000002520
crossref_primary_10_1016_j_hjdsi_2021_100599
crossref_primary_10_3389_fneur_2022_834708
Cites_doi 10.1007/s10900-013-9681-1
10.1016/j.ijsu.2014.07.013
10.1001/jamanetworkopen.2018.1617
10.1161/CIR.0000000000000478
10.1001/jama.2020.8598
10.1016/j.jacc.2020.01.046
10.1016/j.ijcard.2015.02.023
10.2196/jmir.1753
10.1001/jama.2020.6775
10.1016/j.mayocpiqo.2020.07.001
10.2196/jmir.4174
10.1056/NEJM199307293290507
10.1016/j.hrtlng.2020.10.014
10.1056/NEJMra1601705
10.1007/s11605-020-04623-5
10.1093/geront/gny138
10.1001/jamainternmed.2015.2024
10.1016/j.ypmed.2014.04.001
10.1377/hlthaff.2018.05087
ContentType Journal Article
Copyright 2021. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Copyright 2021 Yuan N et al. .
Copyright_xml – notice: 2021. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
– notice: Copyright 2021 Yuan N et al. .
DBID CGR
CUY
CVF
ECM
EIF
NPM
AAYXX
CITATION
3V.
7X7
7XB
8FI
8FJ
8FK
ABUWG
AFKRA
AZQEC
BENPR
CCPQU
COVID
DWQXO
FYUFA
GHDGH
K9.
M0S
PIMPY
PQEST
PQQKQ
PQUKI
PRINS
7X8
5PM
DOI 10.1001/jamanetworkopen.2021.4157
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
CrossRef
ProQuest Central (Corporate)
Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
ProQuest Central (Alumni)
ProQuest Central
ProQuest Central Essentials
ProQuest Central
ProQuest One Community College
Coronavirus Research Database
ProQuest Central Korea
Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Health & Medical Complete (Alumni)
Health & Medical Collection (Alumni Edition)
Publicly Available Content Database
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Academic
ProQuest One Academic UKI Edition
ProQuest Central China
MEDLINE - Academic
PubMed Central (Full Participant titles)
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
CrossRef
Publicly Available Content Database
ProQuest Central Essentials
ProQuest One Academic Eastern Edition
ProQuest Health & Medical Complete (Alumni)
Coronavirus Research Database
ProQuest Central (Alumni Edition)
ProQuest One Community College
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
ProQuest Central China
ProQuest Hospital Collection (Alumni)
ProQuest Central
ProQuest Health & Medical Complete
Health Research Premium Collection
ProQuest One Academic UKI Edition
Health and Medicine Complete (Alumni Edition)
ProQuest Central Korea
ProQuest One Academic
ProQuest Central (Alumni)
MEDLINE - Academic
DatabaseTitleList MEDLINE

Publicly Available Content Database
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
– sequence: 3
  dbid: 7X7
  name: ProQuest - Health & Medical Complete保健、医学与药学数据库
  url: https://search.proquest.com/healthcomplete
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
DocumentTitleAlternate Patient Use and Clinical Practice Patterns of Remote Cardiology Clinic Visits in the Era of COVID-19
EISSN 2574-3805
EndPage e214157
ExternalDocumentID 10_1001_jamanetworkopen_2021_4157
33818619
Genre Journal Article
Research Support, N.I.H., Extramural
GrantInformation_xml – fundername: NHLBI NIH HHS
  grantid: T32 HL116273
– fundername: NHLBI NIH HHS
  grantid: K23 HL153888
GroupedDBID 0R~
53G
7X7
8FI
8FJ
ABUWG
ADBBV
ADPDF
AFKRA
ALIPV
ALMA_UNASSIGNED_HOLDINGS
AMJDE
BCNDV
BENPR
CCPQU
CGR
CUY
CVF
EBS
ECM
EIF
EMOBN
FYUFA
GROUPED_DOAJ
H13
HMCUK
M~E
NPM
OK1
OVD
OVEED
PIMPY
RAJ
TEORI
UKHRP
W2D
AAYXX
CITATION
3V.
7XB
8FK
AZQEC
COVID
DWQXO
K9.
PQEST
PQQKQ
PQUKI
PRINS
7X8
5PM
ID FETCH-LOGICAL-a470t-a31e04ea4b9f70628b8bc0a3a09346dbebdc1993e2c3fb4865d3fa7aee2da73b3
IEDL.DBID COVID
ISSN 2574-3805
IngestDate Tue Sep 17 21:19:59 EDT 2024
Sat Aug 17 04:00:56 EDT 2024
Fri Nov 22 08:48:10 EST 2024
Fri Dec 06 00:35:12 EST 2024
Tue Aug 27 13:50:46 EDT 2024
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 4
Language English
License This is an open access article distributed under the terms of the CC-BY License.
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-a470t-a31e04ea4b9f70628b8bc0a3a09346dbebdc1993e2c3fb4865d3fa7aee2da73b3
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
OpenAccessLink https://proxy.k.utb.cz/login?url=https://www.proquest.com/docview/2667849771?pq-origsite=%requestingapplication%
PMID 33818619
PQID 2667849771
PQPubID 5319538
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_8022216
proquest_miscellaneous_2508893222
proquest_journals_2667849771
crossref_primary_10_1001_jamanetworkopen_2021_4157
pubmed_primary_33818619
PublicationCentury 2000
PublicationDate 2021-04-01
PublicationDateYYYYMMDD 2021-04-01
PublicationDate_xml – month: 04
  year: 2021
  text: 2021-04-01
  day: 01
PublicationDecade 2020
PublicationPlace United States
PublicationPlace_xml – name: United States
– name: Chicago
PublicationTitle JAMA network open
PublicationTitleAlternate JAMA Netw Open
PublicationYear 2021
Publisher American Medical Association
Publisher_xml – name: American Medical Association
References Uscher-Pines (zoi210155r1)
Pekmezaris (zoi210155r4) 2018; 37
Contreras (zoi210155r15) 2020; 24
Merriel (zoi210155r6) 2014; 64
Dorsey (zoi210155r13) 2016; 375
zoi210155r23
Margolis (zoi210155r7) 2018; 1
zoi210155r2
Syed (zoi210155r22) 2013; 38
Choi (zoi210155r17) 2011; 13
Webb Hooper (zoi210155r20) 2020; 323
Brunetti (zoi210155r10) 2015; 184
Hong (zoi210155r18) 2017; 72
Mitchell (zoi210155r19) 2019; 59
Satou (zoi210155r8) 2017; 135
Uscher-Pines (zoi210155r24) 2015; 175
Albert (zoi210155r25) 2020; 49
Kitsiou (zoi210155r5) 2015; 17
Hunt (zoi210155r14) 2020; 4
zoi210155r11
Ayanian (zoi210155r16) 1993; 329
Lopes (zoi210155r9) 2019; 113
von Elm (zoi210155r12) 2014; 12
Sana (zoi210155r3) 2020; 75
Richardson (zoi210155r21) 2020; 323
References_xml – volume: 38
  start-page: 976
  issue: 5
  year: 2013
  ident: zoi210155r22
  article-title: Traveling towards disease: transportation barriers to health care access.
  publication-title: J Community Health
  doi: 10.1007/s10900-013-9681-1
  contributor:
    fullname: Syed
– volume: 12
  start-page: 1495
  issue: 12
  year: 2014
  ident: zoi210155r12
  article-title: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.
  publication-title: Int J Surg
  doi: 10.1016/j.ijsu.2014.07.013
  contributor:
    fullname: von Elm
– volume: 1
  issue: 5
  year: 2018
  ident: zoi210155r7
  article-title: Long-term outcomes of the effects of home blood pressure telemonitoring and pharmacist management on blood pressure among adults with uncontrolled hypertension: follow-up of a cluster randomized clinical trial.
  publication-title: JAMA Netw Open
  doi: 10.1001/jamanetworkopen.2018.1617
  contributor:
    fullname: Margolis
– volume: 135
  start-page: e648
  issue: 11
  year: 2017
  ident: zoi210155r8
  article-title: Telemedicine in pediatric cardiology: a scientific statement from the American Heart Association.
  publication-title: Circulation
  doi: 10.1161/CIR.0000000000000478
  contributor:
    fullname: Satou
– volume: 323
  start-page: 2466
  issue: 24
  year: 2020
  ident: zoi210155r20
  article-title: COVID-19 and racial/ethnic disparities.
  publication-title: JAMA
  doi: 10.1001/jama.2020.8598
  contributor:
    fullname: Webb Hooper
– volume: 113
  start-page: 1006
  issue: 5
  year: 2019
  ident: zoi210155r9
  article-title: Guideline of the Brazilian Society of Cardiology on telemedicine in cardiology - 2019.
  publication-title: Arq Bras Cardiol
  contributor:
    fullname: Lopes
– volume: 75
  start-page: 1582
  issue: 13
  year: 2020
  ident: zoi210155r3
  article-title: Wearable devices for ambulatory cardiac monitoring: JACC state-of-the-art review.
  publication-title: J Am Coll Cardiol
  doi: 10.1016/j.jacc.2020.01.046
  contributor:
    fullname: Sana
– volume: 184
  start-page: 452
  year: 2015
  ident: zoi210155r10
  article-title: Telemedicine for cardiovascular disease continuum: a position paper from the Italian Society of Cardiology Working Group on Telecardiology and Informatics.
  publication-title: Int J Cardiol
  doi: 10.1016/j.ijcard.2015.02.023
  contributor:
    fullname: Brunetti
– volume: 13
  issue: 2
  year: 2011
  ident: zoi210155r17
  article-title: Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey.
  publication-title: J Med Internet Res
  doi: 10.2196/jmir.1753
  contributor:
    fullname: Choi
– volume: 323
  start-page: 2052
  issue: 20
  year: 2020
  ident: zoi210155r21
  article-title: Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area.
  publication-title: JAMA
  doi: 10.1001/jama.2020.6775
  contributor:
    fullname: Richardson
– volume: 4
  start-page: 583
  issue: 5
  year: 2020
  ident: zoi210155r14
  article-title: The effects of COVID-19 on telemedicine could outlive the virus.
  publication-title: Mayo Clin Proc Innov Qual Outcomes
  doi: 10.1016/j.mayocpiqo.2020.07.001
  contributor:
    fullname: Hunt
– volume: 72
  start-page: 856
  issue: 5
  year: 2017
  ident: zoi210155r18
  article-title: Has the digital health divide widened? trends of health-related internet use among older adults from 2003 to 2011.
  publication-title: J Gerontol B Psychol Sci Soc Sci
  contributor:
    fullname: Hong
– ident: zoi210155r2
– volume: 17
  issue: 3
  year: 2015
  ident: zoi210155r5
  article-title: Effects of home telemonitoring interventions on patients with chronic heart failure: an overview of systematic reviews.
  publication-title: J Med Internet Res
  doi: 10.2196/jmir.4174
  contributor:
    fullname: Kitsiou
– volume: 329
  start-page: 326
  issue: 5
  year: 1993
  ident: zoi210155r16
  article-title: The relation between health insurance coverage and clinical outcomes among women with breast cancer.
  publication-title: N Engl J Med
  doi: 10.1056/NEJM199307293290507
  contributor:
    fullname: Ayanian
– ident: zoi210155r11
– volume: 49
  start-page: A11
  issue: 6
  year: 2020
  ident: zoi210155r25
  article-title: Telemedicine in heart failure during COVID-19: like it, love it or lose it?
  publication-title: Heart Lung
  doi: 10.1016/j.hrtlng.2020.10.014
  contributor:
    fullname: Albert
– volume: 375
  start-page: 154
  issue: 2
  year: 2016
  ident: zoi210155r13
  article-title: State of telehealth.
  publication-title: N Engl J Med
  doi: 10.1056/NEJMra1601705
  contributor:
    fullname: Dorsey
– ident: zoi210155r1
  article-title: Telehealth use among safety-net organizations in California during the COVID-19 pandemic.
  publication-title: JAMA
  contributor:
    fullname: Uscher-Pines
– volume: 24
  start-page: 1692
  year: 2020
  ident: zoi210155r15
  article-title: Telemedicine: patient-provider clinical engagement during the COVID-19 pandemic and beyond.
  publication-title: J Gastrointest Surg
  doi: 10.1007/s11605-020-04623-5
  contributor:
    fullname: Contreras
– volume: 59
  start-page: 6
  issue: 1
  year: 2019
  ident: zoi210155r19
  article-title: The digital divide in health-related technology use: the significance of race/ethnicity.
  publication-title: Gerontologist
  doi: 10.1093/geront/gny138
  contributor:
    fullname: Mitchell
– volume: 175
  start-page: 1234
  issue: 7
  year: 2015
  ident: zoi210155r24
  article-title: Antibiotic prescribing for acute respiratory infections in direct-to-consumer telemedicine visits.
  publication-title: JAMA Intern Med
  doi: 10.1001/jamainternmed.2015.2024
  contributor:
    fullname: Uscher-Pines
– volume: 64
  start-page: 88
  year: 2014
  ident: zoi210155r6
  article-title: Telehealth interventions for primary prevention of cardiovascular disease: a systematic review and meta-analysis.
  publication-title: Prev Med
  doi: 10.1016/j.ypmed.2014.04.001
  contributor:
    fullname: Merriel
– ident: zoi210155r23
– volume: 37
  start-page: 1983
  issue: 12
  year: 2018
  ident: zoi210155r4
  article-title: Home telemonitoring in heart failure: a systematic review and meta-analysis.
  publication-title: Health Aff (Millwood)
  doi: 10.1377/hlthaff.2018.05087
  contributor:
    fullname: Pekmezaris
SSID ssj0002013965
Score 2.4417784
Snippet The COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. To understand whether the transition...
Importance The COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. Objective To understand...
ImportanceThe COVID-19 pandemic has led to an unprecedented shift in ambulatory cardiovascular care from in-person to remote visits. ObjectiveTo understand...
This cross-sectional study examines ambulatory cardiology clinic visit data and whether the transition to remote visits during COVID-19 is associated with...
SourceID pubmedcentral
proquest
crossref
pubmed
SourceType Open Access Repository
Aggregation Database
Index Database
StartPage e214157
SubjectTerms Aged
Aged, 80 and over
Ambulatory Care
Ambulatory Care Facilities
Cardiology
Cardiology - methods
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - therapy
Coronaviruses
COVID-19
Cross-Sectional Studies
Ethnic Groups
Female
Health Policy
Healthcare Disparities
Hispanic people
Humans
Insurance, Health
Male
Middle Aged
Online Only
Original Investigation
Pandemics
Patient Acceptance of Health Care
Patients
Practice Patterns, Physicians
SARS-CoV-2
Telemedicine
Telemedicine - methods
Title Patient Use and Clinical Practice Patterns of Remote Cardiology Clinic Visits in the Era of COVID-19
URI https://www.ncbi.nlm.nih.gov/pubmed/33818619
https://www.proquest.com/docview/2667849771
https://search.proquest.com/docview/2508893222
https://pubmed.ncbi.nlm.nih.gov/PMC8022216
Volume 4
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3db9MwED-xVUK88CG-MkblSbym1LETJ08ISqeBxKgmOvUtsuOLqEDpWNqX_fXcJW5Zh8QDzznFH3f2_Xw-_w7gjUFCBb7C2Fa0mjQh7tjmTsZVmvoizzIyEQ7ofznPzub68yJdhIBbG9Iqt3tit1H7VcUx8rfkSEyuCa3Id1e_Yq4axberoYTGAQwUQQey8MHk6-Wnj7soS8IIJ0vvw8ltuqGmz7Dm-lR0QkzkiLyY2XdMf6HNu0mTt7zQ6SMot_3vk09-jDZrN6pu7lA7_v8AH8PDAFDF-96insA9bJ6Cn_X0q2LeorCNF4FO9KeYhVdWYtYRdTatWNXiAskAUEy6XFcO2wd5cbmk1lqxbAThTjG9tizdzWUsi2cwP51-m5zFoT5DbLUZr2OrJI41Wu2K2vBbTJe7amyVHRdKZ96h8xXnB2JSqdrpPEu9qq2xiIm3Rjn1HA6bVYMvQSCz2sjaYZEWunZFXktMJc2HdZZOdCqCZKuc8qqn4Sh7wmU6vuxrtGSNlqzRCI63M12GldmWf6Y5gpPdZ1pTfFFC_1ltSIZRa8F3UBG86LW-a1UxxKFTZwRmzx52AszXvf-lWX7veLv5VXMis6N_d-sVPOAR9NlBx3C4vt7gawI-azeEA7MwQxh8mJ7PLobB1oddGOE3YlAMrg
link.rule.ids 230,314,780,784,864,885,12056,21388,27924,27925,31719,31720,33744,33745,38516,43310,43805,43895
linkProvider ProQuest
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3dT9swED-xIm28bEz7IIMxI-01XR07X08T6kCFAasminiL7PiiVZtSRtqX_fW7S9yOMokHnmPF9t3Z_t35_DuAjykSKnAlhqak1aQJcYcmszIs49jlWZKQiXBA__wiGU306XV87QNujU-rXO6J7UbtZiXHyD_RQZJmmtCK_HzzO-SqUXy76ktoPIFNruId92Bz-O3q5MsqyhIxwknip3Bwl26o7jKsuT4VeYiR7NMplq4fTP-hzftJk3dOoeMXUCzH3yWf_Owv5rZf_rlH7fj4CW7Dcw9QxWFnUS9hA-tX4MYd_aqYNChM7YSnE_0lxv6VlRi3RJ11I2aV-I5kACiGba4rh-19e3E1pd4aMa0F4U5xdGu4dSvLUOavYXJ8dDkchb4-Q2h0OpiHRkkcaDTa5lXKbzFtZsuBUWaQK504i9aVnB-IUakqq7MkdqoyqUGMnEmVVW-gV89q3AGBzGojK4t5nOvK5lklMZYkD2MNeXQqgGipnOKmo-EoOsJlcl_WNVqwRgvWaAB7S0kXfmU2xT8xB3Cw-kxrii9K6D-zBbVh1JrzHVQAbzutr3pVDHHI6wwgXbOHVQPm617_Uk9_tLzd_Ko5ksm7h4f1AZ6NLs_PirOTi6-7sMWz6TKF9qA3v13gewJBc7vvLf0vK_oMKA
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Patient+Use+and+Clinical+Practice+Patterns+of+Remote+Cardiology+Clinic+Visits+in+the+Era+of+COVID-19&rft.jtitle=JAMA+network+open&rft.au=Yuan%2C+Neal&rft.au=Pevnick%2C+Joshua+M.&rft.au=Botting%2C+Patrick+G.&rft.au=Elad%2C+Yaron&rft.date=2021-04-01&rft.issn=2574-3805&rft.eissn=2574-3805&rft.volume=4&rft.issue=4&rft.spage=e214157&rft_id=info:doi/10.1001%2Fjamanetworkopen.2021.4157&rft.externalDBID=n%2Fa&rft.externalDocID=10_1001_jamanetworkopen_2021_4157
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2574-3805&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2574-3805&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2574-3805&client=summon