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Two different editorials were published in @CircAHA and @JAMAHealthForum on the push for home-based cardiac rehab (HBCR), so I figured I would do a quick #CQOSpotlight on the topic.
I think we could all use a distraction!
I think we could all use a distraction!
CR has already been shown to have significant benefits to patients with CV disease (e.g., AMI, PCI/CABG, HF, etc.), but <1/3 of pts attend a single session!
HBCR was designed as an alternative to facility-based CR thru indirect exercise monitoring
#CQOSpotlight #telehealth
HBCR was designed as an alternative to facility-based CR thru indirect exercise monitoring
#CQOSpotlight #telehealth
The idea of HBCR is not new, but has also not taken off. In 2017, Cochrane published a systematic review by Anderson et al that included findings from 23 RCTs.
Whats the verdict? HCBR seems similarly effective to facility-based CR.
https://pubmed.ncbi.nlm.nih.gov/28665511/
Whats the verdict? HCBR seems similarly effective to facility-based CR.
https://pubmed.ncbi.nlm.nih.gov/28665511/
In 2019, the @American_Heart released a scientific statement advocating for more research and demonstration projects that support HBCR as an effective alternative to facility-based CR.
#CQOSpotlight #telehealth https://www.ahajournals.org/doi/10.1161/CIR.0000000000000663
#CQOSpotlight #telehealth https://www.ahajournals.org/doi/10.1161/CIR.0000000000000663
The fantastic team over at @HenryFordNews recently published a case series discussing how they used #telehealth to deliver HBCR in two pts that otherwise would not have attended facility-based CR. Highly recommend checking it out. https://journals.lww.com/jcrjournal/Abstract/2020/07000/Telemedicine_Home_Based_Cardiac_Rehabilitation__A.5.aspx
When the pandemic hit, facility-based CR use effectively stopped. Anecdotally, I know that most facilities have started operations again (for the time being) but at reduced capacity, and are working off of enormous backlogs.
#CQOSpotlight #telehealth
#CQOSpotlight #telehealth
In October, CMS expanded emergency #telehealth coverage to include HCBR, in hopes that it would increase access to CR for patients during a time of reduced capacity.
#CQOSpotlight
https://www.cms.gov/newsroom/press-releases/trump-administration-drives-telehealth-services-medicaid-and-medicare
#CQOSpotlight
https://www.cms.gov/newsroom/press-releases/trump-administration-drives-telehealth-services-medicaid-and-medicare
The article in @CircAHA interviews @HenryFordNews team re: the pandemic has pushing HBCR front-and-center, discusses barriers to CR attendance (e.g., work, transportation, copays, caregiver support), and the lack of payer support for HBCR.
#CQOSpotlight https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.051769
#CQOSpotlight https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.051769
A really cool story here in MI is that @HenryFordNews worked with @BCBSM and @hapmichigan to reimburse for HBCR with the understanding that it would retain the same quality and documentation as facility-based CR. Worth watching for impact.
#CQOSpotlight #telehealth
#CQOSpotlight #telehealth
The editorial in @JAMAHealthForum discusses the potential of HBCR, but from the perspective of improving access. Right now, CR programs can serve 37% of eligible US pts.
Expanding HBCR may be an opportunity to expand access.
#CQOSpotlight #telehealth https://jamanetwork.com/channels/health-forum/fullarticle/2772795
Expanding HBCR may be an opportunity to expand access.
#CQOSpotlight #telehealth https://jamanetwork.com/channels/health-forum/fullarticle/2772795
Some parting thoughts on future of HBCR:
- More evidence needed on HBCR vs facility-based CR
- Need innovative solutions to deliver HBCR with #telehealth
- Have to solve reimbursement barriers to HBCR
Where do you think HBCR fits into CV care landscape?
#CQOSpotlight
- More evidence needed on HBCR vs facility-based CR
- Need innovative solutions to deliver HBCR with #telehealth
- Have to solve reimbursement barriers to HBCR
Where do you think HBCR fits into CV care landscape?
#CQOSpotlight
