The pandemic was an unexpected challenge that called for an extraordinary response. MedStar Heart & Vascular Institute made many innovative adaptations to its practices across the board. Among these was expanding the use of existing virtual platforms and creating new ones in rapid-fire time to facilitate patient and provider safety—while continuing to deliver the high quality, advanced specialty care that has distinguished the Institute for decades.

Virtual patient visits transform ambulatory care.

COVID-19 called for an immediate remedy to allow thousands of patients throughout the region to meet safely with their physicians. MedStar Health rapidly produced the systemwide platform necessary to implement telehealth capabilities.

A team of ambulatory care cardiovascular physicians from both the Washington and Baltimore regions came together in partnership to development a protocol and establish the infrastructure necessary to make virtual appointments effective. A variety of communication tools were employed to reach patients: emails, phone calls, texts, mail, MedStar Patient Portal, media, and the Web. Physicians are recognizing the real value of seeing patients in their home setting and are reporting seeing some patients for longer periods of time than in-office visits might afford them.

Almost all cardiology outpatient visits are conducted through audio and video formats. Among the ambulatory care cardiovascular physicians in the Washington region, the largest such group in the area, patient visits amount to approximately 100 percent of the number of visits during the same period last year—but this year, they are nearly all virtual.

“Moving forward, we will be able to more closely monitor the clinical status of our patients regardless of where they live or work. Not only will this avoid potentially unnecessary site visits, but it will assuredly reduce the time for a patient to get a physician appointment, decrease hospital length of stay, and most importantly, positively impact the quality of care being delivered.“

—George Bittar, MD, Regional Director, Ambulatory Cardiovascular Services, Baltimore Region

“Our telemedicine capabilities were up and running in a week—the tremendous institutional push was remarkable.“

—Robert Lager, MD, Regional Director, Ambulatory Cardiovascular Services, Washington Region

Cardiac cath lab augments technology to keep clinicians and patients informed and safe.

Many conditions necessitating treatment in the cardiac catheterization lab persisted during the pandemic. Modifications were needed across many areas, including the physical layout of the lab, patient transportation routes, preservation and appropriate donning and doffing of PPE, virus screening, triaging patients by risk and need, and the safety of the care team. Amidst these adaptations, MedStar Heart & Vascular Institute interventionalists recognized virtual platforms as an effective conduit for managing patient care.

  1. Using the web-based tool ImageShare, key cardiovascular physicians conduct virtual meetings to review imaging of patients from referring physicians in hospitals throughout the region to quickly determine the need for urgent transfer for specialized treatment.
  2. An algorithm addressing protocols for treatment of STEMIs in suspected and COVID-19 positive patients was developed and put into place in record time, preventing unnecessary delays in both treatment in the cath lab and risk of contagion to others.
  3. Internal multidisciplinary conferences to evaluate and discuss patients with advanced valvular and structural issues, once held in person, are now web-based.
  4. The MedStar Health telemedicine platform supported rapid discharge and reduced hospitalizations when possible, allowing for effective follow-up at home.
  5. Through teleconferencing platforms, physicians conducted a continuing series of informational meetings with up to 30 referring doctors at a time to keep them abreast of safety measures and specialized procedures being used, and to ensure them that their patients should not avoid a needed hospital visit.