Heart failure & cardiomyopathies
Changes in Clinician Telemedicine Use and Care Patterns for Patients With Heart Failure in the United States
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
- Outcome
- Ordering of diagnostic tests
Methodological detailsnegative binomial regression with adjustment for the period, number of patients, and clinician random intercepts, single academic cardiovascular center
- Negative binomial regression with adjustment for the period, number of patients, and clinician random intercepts
- Single academic cardiovascular center
Main finding
As reported in the abstract
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
| Incident rate ratio (95% CI) | ||
|---|---|---|
| 50-percentage-point increase in telemedicine useAldosterone antagonists | 0.72 (0.52–0.99) | |
| 50-percentage-point increase in telemedicine useTotal 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.
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