Heart failure & cardiomyopathiesCohort study
Changes in Clinician Telemedicine Use and Care Patterns for Patients With Heart Failure in the United States
- Retrospective analysis of electronic health record data
- negative binomial regression with adjustment for the period, number of patients, and clinician random intercepts
- single academic cardiovascular center
Authors' conclusion
Greater clinician telemedicine use was associated with decreased diagnostic testing for patients with HF and reduced guideline-directed medical therapy initiation for patients with HF with reduced ejection fraction. Novel interventions are needed to ensure guideline-concordant care regardless of care modality.
Study context
- Population
- Patients with heart failure (HF) at an academic cardiovascular center in Northern California, March 2019 to May 2023n = 7741, patients seen by 44 clinicians (1941 patients with HF with reduced ejection fraction seen by 28 clinicians)
- Exposure
- Clinician-period ordering rates by telemedicine use (proportion of visits via video/phone), per 50-percentage-point increase
Main finding
As reported in the abstract
Ordering of diagnostic tests
50-percentage-point increase in telemedicine useIncident rate ratio (95% CI)
electrocardiograms
0.30(0.25–0.35)
echocardiograms
0.70(0.59–0.82)
natriuretic peptide tests
0.66(0.49–0.88)
chemistry panels
0.66(0.56–0.76)
Observational data: associations, not effects.
Further findings
New prescriptions, HF with reduced ejection fraction subgroup
| Comparison | incident rate ratio (95% CI) | |
|---|---|---|
| 50-percentage-point increase in telemedicine use · aldosterone antagonists | 0.72 (0.52–0.99) | |
| 50-percentage-point increase in telemedicine use · total guideline-directed medical therapy | 0.80 (0.69–0.94) | |
| 0.512Incident rate ratio (log scale) |
- New prescriptions, HF with reduced ejection fraction subgroup: subgroup: 1941 patients seen by 28 clinicians
Baseline characteristics
- Mean age
- 65 years (SD, 16.8)
- Female
- 41%
Original publication
Changes in Clinician Telemedicine Use and Care Patterns for Patients With Heart Failure in the United States. Circ Popul Health Outcomes. Published 13 January 2026. doi:10.1161/circoutcomes.125.012089
Summarised from the published abstract; every number is checked against it