A June editorial in the New England Journal of Medicine discusses the role of telemanagement in connecting primary care physicians and their patient cohorts in remote areas with specialists when care requires consultation. Highlighting results from the ECHO (Extension for Community Healthcare Outcomes) Program, which connected PCPs with specialists via videoconferencing, the author notes the positive outcomes of such a collaboration: the rate of sustained virologic response among hepatitis C patients being treated at the AMC was similar to that of those patients being treated by PCPs in remote consult with specialists.
ECHO's success suggests that such virtual consults are able to drive the same patient outcomes as in-person care collaboration. The results of the program have interesting repercussions for cardiology, especially in light of the new care delivery models being adopted by organizations around the country. Many cardiovascular physicians are now looking to define their role in accountable care organizations and other types of developing models.
Of particular relevance to cardiologists are Patient-Centered Medical Homes (PCMHs), enhanced primary care practices designed to offer comprehensive care, particularly for the chronic and multi-morbid patient population. The prevalence of heart failure suggests a role for cardiologists in this type of delivery model, yet the specific role for cardiovascular physicians remains undefined. Should some cardiologist practices actually transform into full-fledged medical homes, or is the optimal role less involved, perhaps managing high acuity patients on a regular basis, while serving in a consultative role in most circumstances? In such instances, telemanagement as deployed by the ECHO program may be an effective way of connecting cardiologists with PCPs when care requires it.
Mastering the Care Continuum, one of the studies to launch at the Cardiovascular Roundtable's 2011 National Meeting Series this fall, will examine and offer analysis on many of the issues surrounding telemanagement, the role of cardiologists in medical homes, and how cardiovascular service lines should develop and execute a fully comprehensive care continuum. To register for one of the meetings, please click here
(Sequist, New England Journal of Medicine, 6/9).