For doctors in the field of cardiac electrophysiology, monitoring patients’ heart health remotely is nothing new.
In the 1970s, monitoring systems for cardiac pacemakers transmitted signals by telephone. These signals enabled cardiac electrophysiologists (EPs) to make sure their patients’ heart rhythms were consistent and their pacemakers were working correctly.
Today, cardiac EPs have more tools at their disposal to track patients’ heart health. Just ask Dr. Janet K. Han, who has developed an innovative telecardiology program at the Greater Los Angeles VA.
Dr. Janet K. Han
Han is the assistant director of Los Angeles VA’s cardiac arrhythmia service and the director of the arrhythmia service’s digital health program. She uses telehealth and digital health tools to care for Veterans with irregular heartbeats.
“Cardiac EPs are probably the biggest nerds of all cardiologists,” Han said. “We’re really good at doing remote monitoring, we’re great with devices and we love our technology. So, I thought we’d be a great specialty to see if our patients could benefit from telehealth.”
Han said the Los Angeles VA telecardiology program, which she helped establish in early 2020, has kept Veterans with cardiac arrhythmias healthy, helped them avoid emergency room visits and provided them with uninterrupted care throughout the pandemic.
Using digital tools to monitor from a distance
Remote monitoring starts with the cardiac pacemaker. Unlike the clunky devices submitting telephone signals in the 1970s, modern pacemakers and defibrillators send data via small, portable Bluetooth devices. This has made monitoring heart rhythms much more convenient for Veterans.
“You put the monitor at the bedside and it automatically checks the pacemaker or defibrillator in the middle of the night,” said Han. “It sends us data through the internet, and we can check on Veterans and see how their heart rhythm is.”
Along with monitoring pacemaker readings remotely, Han and her team teach Veterans how to check their heart rate and rhythm using smartwatches, electrocardiogram (EKG) devices, or mobile apps. EKGs measure heart activity and can detect issues with heart rhythm. “That helps us to be able to monitor our arrhythmia patients very, very well,” Han said.
No more four hours in traffic for a 15-minute visit
Veterans in the Los Angeles VA telecardiology program connect virtually with their cardiac EPs through the VA Video Connect app. Han said these video visits let Veterans receive face-to-face care from their VA providers without making a trip to a VA medical center.
“That’s one thing I think Veterans really like,” said Han. “They don’t have to fight traffic for four hours for a 15-minute visit.”
And when Veterans experience irregular EKG readings, Han said, VA Video Connect enables them to connect quickly with their providers and get a plan of action.
The program has the added benefit of engaging Veterans in their own care. “Veterans are keeping track of, and sending me, data that we can look over together,” she said. “When they become comfortable with that technology, they become a partner in their health care. That’s key to getting telehealth to work.”
Serving Veterans during the pandemic
The onset of the COVID-19 pandemic increased the need for virtual care options. Jeffrey Maynard, a Veteran with a heart arrhythmia who receives care from Los Angeles VA, said he relies on virtual visits to avoid exposing an immunocompromised family member to COVID-19.
“Telehealth allows me to stay in contact with my doctors,” he said. “It is important to me that my doctors can see me and I can see them while we discuss my health and the options available to me. There are devices that work in conjunction with my smartphone to record and track my vitals. And then I can share those readings virtually.”
Dr. Richard Schofield is VA’s national director for cardiology in the Office of Specialty Care Services. He said cardiology patients nationwide are receiving outstanding care through telehealth.
“We’ve put a lot of resources into facilitating virtual care and I think that’s really been paying off and will continue to pay off,” Schofield said. “We’re looking forward to even bigger and better things in the future.”
Learn more on the Telehealth Services website.