Virtual Visits in Heart Failure Care Transitions

The Cleveland Clinic116 enrolled

Overview

This study evaluates the use of virtual visits in the post-discharge care of patients with heart failure. Participants admitted to the hospital with a primary diagnosis of heart failure will be randomized at discharge to either a virtual visit or outpatient visit for their 7-day post discharge follow up visit.

Published guidelines recommend that patients being discharged home after hospitalization for HF should be offered a 7-day post-discharge outpatient clinic visit as a way to increase engagement with care and reduce risk of poor outcomes. Unfortunately no-show rates for the 7-day post-discharge outpatient visit in this population are high, suggesting poor engagement. The investigators have previously observed a 76% no-show rate at the Cleveland Clinic Main Campus. This study is to evaluate whether use of 7-day post-discharge virtual visit versus in-person visit can improve adherence with post-discharge appointment.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

116

Conditions

Heart Failure

Interventions

Virtual VisitBEHAVIORAL

The Cleveland Clinic Express Care Online application will be used in this intervention. The subjects will have a virtual consult with a clinician from the study team that will mirror an experience had at an outpatient post-discharge visit, including review of systems and medications.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: 1. Hospitalized for primary diagnosis of HF; 2. Anticipated to be discharged home; 3. Agreeable to longitudinal post-discharge care at Cleveland Clinic Main Campus in the first few weeks after hospital discharge; 4. Patient or an individual in their social support network has the ability (equipment and connectivity) to do a virtual visit after hospital discharge; Exclusion Criteria: 1. Being transferred to another hospital, or being discharged to an inpatient facility or nursing home; 2. Being discharged to hospice; 3. Subject currently enrolled in an interventional research study that requires an in-person clinical visit within 7 days post-discharge.

Locations (1)

Cleveland Clinic

Cleveland, Ohio, United States

Outcomes

Primary Outcomes

Proportion of completed post discharge visits via virtual visit or in outpatient setting

Proportion of patients who complete 7-day post discharge appointment (virtually or in-person)

Time frame: 12 months

Secondary Outcomes

45-day unplanned readmission and death measures stratified by visit method (virtually or in-person)

Composite and individual components of unscheduled all-cause first occurrence of (a.) hospital readmission, (b.) emergency department visit, or (c.) death, in the first 45 days after hospital discharge.

Time frame: 12 months

Data from ClinicalTrials.gov

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