Heart Failure
Conditions
Keywords
Heart Failure, Distance Health, Virtual Health
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALVirtual Visit
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.
Sponsors
The Cleveland Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of completed post discharge visits via virtual visit or in outpatient setting | 12 months | Proportion of patients who complete 7-day post discharge appointment (virtually or in-person) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 45-day unplanned readmission and death measures stratified by visit method (virtually or in-person) | 12 months | 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. |
Countries
United States
Outcome results
None listed