Background
The COVID-19 pandemic profoundly impacted healthcare services globally. This in turn, expedited digitalization in its response to new norms. Technological means were heavily explored in healthcare delivery especially in patient management and treatment. Implementation of telemedicine on outpatient clinic was ideal amongst closely monitored patients such as those with heart failure. Heart failure patients were ideal candidates for such delivery services as means of communication were already established prior to patient enrolment.
Objective
To study the impact of telemedicine on heart failure hospital admissions and mortality among the heart failure frequent flyer programme patients.
Methodology
This is a retrospective observational study involving adaptation of outpatient care delivery through telemedicine on Hospital Tengku Ampuan Rahimah heart failure frequent flyer program patients. Incapability of physical healthcare services delivery prompted diverse forms of communication between patients and healthcare providers. The communications were performed using social media platforms such as WhatsApp or virtual platforms such as Google Meet. Communication between patients from the heart failure clinic and the Heart Failure team with morbidity and mortality were analysed.
Results
Our study consisted of 38 patients, with a male majority at 88%. More than half of our cohort utilized various platforms for the adopted outpatient management. Approximately 30% of our cohort had virtual assessment with more than half favouring Google Meet. WhatsApp message exchanges were commonly seen with a mean of 2.5 messages per patient. A total of eight deaths were documented among our cohort. The cause of death was attributed to Non-ST Elevation Myocardial Infarction, Ruptured Aortic Abdominal Aneurysm, Septicaemia and COVID-19 infection. Correlation by Phi and Cramer's V between patients' communication and outcome of mortality showed significance at p value <0.05. Apart from that, there was no documented hospital readmission for decompensated congestive heart failure on surviving patients.
Conclusion
Virtual assessment via telemedicine in heart failure patients are challenging but highly effective if done right. In addition, rapid transformation and adoption of telemedicine utilizing all forms of communication between primary care provider and patients showed an immense role in morbidity and mortality reduction.