Cardiologists’ perceptions on telehealth practices and limitations during and following the COVID-19 pandemic

Background While telehealth utilization has decreased following the COVID-19 pandemic, the incorporation of remote visits into ambulatory cardiology practice guidelines remains a necessity. The aim of this study was to survey cardiologists’ perceptions on telehealth practices post-pandemic, and to propose clinical workflow models for remote visit types. Methods A 25-item survey was distributed to 481 American College of Cardiology CardioSurve panelists from 14 April 2023 through 11 May 2023. Descriptive analyses were conducted to evaluate provider demographics and reported percentages of responses to opinions and statements in the questionnaire. Chi-square and Fisher's exact tests were performed to determine statistically significant associations between categorical variables. Kruskal–Wallis H tests were performed on telemedicine visit frequency offered before, during, and after the pandemic. Results Seventy percent of respondents continue to offer telemedicine visits post-pandemic. Early career cardiologists were more likely to offer telemedicine visits compared to later career colleagues ( p = 0.004). The odds ratio for offering telemedicine visits for early career compared to late-career was 5.56 (95% CI [1.910, 16.277]) and 1.394 (95% CI [0.594, 3.269]) for mid-career compared to late-career. Sixty-three percent of respondents reported that lack of reliable internet access posed challenges for outpatient visits, and approximately one-third believed that the risk for malpractice increased when providing care remotely. Only 22% of cardiologists reported the use of telepresenters. Three clinical workflow models were then constructed to address potential barriers to telehealth implementation. Conclusions Cardiologists continue to offer telehealth visits, but concerns persist regarding the feasibility and appropriateness for a variety of ambulatory encounter types. To address these concerns, we have proposed several models for telehealth integration into various outpatient settings to optimize access to care and lighten the burden placed on an already diminishing cardiology workforce.