Feasibility and Patient Perceptions of Tele-Videoconferencing Visits for LVAD Patients (TeleLVAD Study)

Purpose The number of advanced heart failure patients supported by a left ventricular assist device (LVAD) is increasing, but patient access to LVAD providers is limited by distance and distribution of specialists. This prospective study was designed to determine whether tele-videoconferencing visits could be used as an alternative to in-person office visits for LVAD patients. Methods Patients supported by a continuous-flow LVAD participated in one tele-videoconferencing visit at a remote site and one standard in-person office visit at a tertiary medical center. Outcome measures included technical feasibility and ability to complete a comprehensive clinical examination, adverse events within two weeks of the visit, and patient perceptions evaluated by the validated Telehealth Usability Questionnaire (TUQ). Results Participants in the study (mean age 58 years, 91% male, 36% destination therapy) were supported by a LVAD for a mean of 21 months (range 3-61 months). Eleven patients participated in the study and completed tele-videoconferencing visits at two different remote sites located 40 and 90 miles from the tertiary medical center. Clinicians were able to complete all components of a VAD clinical exam during the tele-videoconferencing visits and made medication and LVAD speed changes remotely at a similar rate to the in-person office visits (Table). There were no rehospitalizations within two weeks of the tele-videoconferencing visits. Patients had a 99% positive response to questions in the TUQ and saved an average 59 minutes of travel time during tele-videoconferencing visits. Conclusion Tele-videoconferencing visits can be used to complete a comprehensive clinical examination in LVAD patients with high patient satisfaction. This management approach may be used to reduce healthcare utilization in LVAD recipients.