Recent research shows almost half of U.S. counties don’t have a practicing cardiologist. The fact that more than 22 million Americans must travel nearly 90 miles round trip to seek this expertise should be shocking. Sadly, though, many of us in healthcare are likely unsurprised by this news.
The cost of cardiology care deserts
The National Rural Health Association (NRHA) reports that there are roughly 30 specialists available per 100,000 people in rural areas. That’s a staggeringly small number compared to the 263 specialists per 100,000 residents in urban regions. The disparity is especially concerning when we consider that heart disease is the leading cause of death in the United States and accounts for a whopping $219 billion in healthcare cost each year.
These specialty care “deserts” affect 20% of the U.S. population. While primary care doctors in the community do a great job managing the day-to-day needs of their patients, complex cardiovascular conditions often call for a specialist. No doctor can know every aspect of medicine, and misdiagnoses can have serious consequences.
Research shows 800,000 people suffer “serious harm” from misdiagnosis every year in the United States. Further, 22% of diagnostic errors leading to death or permanent disability were linked to vascular issues. Aside from the harm caused to patients, misdiagnoses also come with a large price tag: $100 billion annually, by some estimations.
These healthcare deserts aren’t just inconvenient. They can put patients’ lives at risk and greatly increase the chances of misdiagnosis, leading to poor outcomes and unnecessary cost. In today’s digital age, patients — and the healthcare system, at large — must find novel, digital solutions to close the specialty care gap.
Opening the door to virtual solutions
The good news for patients and specialists is that virtual solutions are becoming more sophisticated every day to eliminate these care deserts. To reach patients across the country, a modern cardiology program must embrace the most promising, digitally enabled strategies:
Wearables – Aside from the Apple Watch and other mainstream devices, new categories of “medical grade” wearables, purpose-built to monitor and address specific health conditions, are likewise becoming more accessible. These devices generally have more sensitive sensors compared to consumer devices and have been cleared by the FDA to gather data to support clinical decision-making. While many patients can benefit from wearables — both medical-and consumer-grade-devices alone won’t solve the issue of healthcare deserts. For instance, recent research shows that some patients are more anxious and prone to monitor their symptoms more if they are using a device like a smart watch. To make a positive impact on patients’ health and curb concern, these tools must still be paired with readily accessible specialist expertise that can correctly analyze the data to guide effective treatment plans.
Virtual specialist care – While overall telehealth volume subsided from the pandemic peak, usage remains high for medical specialists. Nearly three out of four specialists said they could provide a similar quality of care via telehealth compared to in-person visits. Most specialist respondents (63%) also reported satisfaction with current telehealth technology, meaning that their continued use of virtual care tools will likely remain high. Patients have seen remarkable outcomes by using virtual care, from successfully managing diabetes to avoiding unnecessary heart transplants. Likewise, providers can see the benefits of virtual care within their own practices.
Virtual peer-to-peer provider consultations – Providers often collaborate with each other, and we’re seeing more emphasis on multidisciplinary care as value-based models continue to grow. Research demonstrates that multidisciplinary care, including through virtual care, boosts patient outcomes. One study showed that virtual peer-to-peer consultation in hospitals led to increased guideline-directed medical therapy for heart failure.
But patients aren’t the only ones who benefit from virtual provider collaboration. One Canadian study found that virtual peer-to-peer consultation between primary care providers (PCPs) and specialists negated the need for in-person specialist referrals, and simultaneously increased patient satisfaction with both PCP and specialist providers.
At a time when patients need expertise from cardiologists and other specialists more than ever, the lack of equitable access to these providers is unacceptable. To truly improve cardiac care across our nation, we have to advance specialty care access through digital tools. While patients may be quick to adopt easy-to-use wearable devices, their use must be guided by an expert specialist to ensure peace of mind. Likewise, PCPs that collaborate with these specialists, even virtually, not only increase the likelihood of strong patient outcomes, but also improve satisfaction.
As more and more patients struggle with heart-related conditions, virtual care holds the key to unifying all stakeholders to move the needle on heart care across the country.
Photo: mediaphotos, Getty Images
Frank McGillin is the CEO at The Clinic by Cleveland Clinic, a joint venture between Cleveland Clinic and Amwell that expands access to the world’s best healthcare expertise through digital technology. The Clinic enables patients to access Cleveland Clinic’s deep and comprehensive medical expertise virtually, including 3,500 physicians in 550 advanced subspecialties. The Clinic offers fully secure video consultations, digital record collection and concierge-level service to patients, health plans and more.
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