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. 2020 Dec 25;2(1):55-62.
doi: 10.1016/j.cvdhj.2020.12.001. eCollection 2021 Feb.

Changes in the digital health landscape in cardiac electrophysiology: A pre-and peri-pandemic COVID-19 era survey

Janet K Han  1 , Sana M Al-Khatib  2 , Christine M Albert  3
Affiliations

Changes in the digital health landscape in cardiac electrophysiology: A pre-and peri-pandemic COVID-19 era survey

Janet K Han et al. Cardiovasc Digit Health J. .

Abstract

Background: Digital health is transforming healthcare delivery.

Objective: To compare the current digital health landscape in select groups of cardiac electrophysiology (EP) professionals prior to and during the COVID-19 era.

Methods: Two online surveys were emailed to 4 Heart Rhythm Society communities and tweeted out to Twitter EP, 1 before and 1 during the pandemic. Categorical variables were analyzed using the χ 2 test and reported as absolute numbers and percentages.

Results: There were 253 pre-pandemic (S1) and 273 follow-up surveys (S2) completed. The majority of respondents to both surveys were male, aged <55 years (70.6% vs 75.1%), university-affiliated (52.6% vs 55%), and physicians (83.3% vs 87.9%). Between S1 and S2, routine use of video-telehealth increased (5.9% vs 58.6%; P < .001) for all types of consultations (P < .001 for all). Wireless electrocardiogram prescribing was prevalent and similar (80.2% vs 81.0%), whereas wireless blood pressure monitoring (9.9% vs 18.3%) and wireless oximetry (1.6% vs 8.1%; P = .006 for both) prescribing both increased. For smartphone mobile applications (mApps), prescriptions for heart rate mApps decreased (50.6% vs 40.7%; P = .022), while vital sign (28.9% vs 37%; P = .04) and symptom trackers (15.8% vs 24.9%; P = .01) prescribing increased. A majority in both surveys (84.6% vs 75.5%) reported no workplace infrastructure or support for digital health with concerns for lack of parity in reimbursement.

Conclusion: Our results show an increase in adoption of digital health by EP during the COVID-19 pandemic. Concerns regarding a lack of supportive infrastructure persisted. Development of professional society guidelines on optimal clinical workflow, infrastructure, and reimbursement may help advance and sustain digital health integration in EP.

Keywords: Digital health; Mobile applications; Telehealth; Wearables.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Comparison of self-characterization of digital health adoption, Survey 1 (pre-pandemic) vs survey 2 (peri-pandemic). Categories based on Rogers. ∗ = statistically significant as listed in figure legend.
Figure 2
Figure 2
Comparison of digital health tool (A) and smartphone mobile application (mApp) (B) prescribing, survey 1 (pre-pandemic) vs survey 2 (peri-pandemic). ∗ = statistically significant as listed in figure legend. BP = blood pressure; ECG = electrocardiogram; Peri = peri-pandemic; Pre = pre-pandemic.
Figure 3
Figure 3
Comparison of perceived barriers (A) and benefits (B) to digital health, survey 1 (pre-pandemic) vs survey 2 (peri-pandemic). Lower number signifies greater importance. Peri = peri-pandemic; Pre = pre-pandemic.
See this image and copyright information in PMC

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