Kaiser Permanente’s Virtual Cardiac Monitoring – Pioneering Remote Care During COVID-19

Dr. Siobhan Gray, Medical Director for Virtual Cardiac Monitoring at Kaiser Permanente

Brand Story – How Kaiser Permanente leveraged its digital prowess to care for vulnerable patients.

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 By the start of 2020, Kaiser Permanente already had a Virtual Cardiac Rehab (VCR) Center, doctors trained in telemedicine and a pacemaker/implantable cardioverter defibrillator department that went virtual a decade ago. With the arrival of COVID-19, the health care organization quickly worked to scale its remote cardiac services even further. The result? A highly effective virtual cardiac event monitoring solution.

When the pandemic began limiting the ability of patients to safely proceed with heart monitoring, Kaiser Permanente’s Cardiac Rhythm Monitor team had to act fast.

“Without adding additional virtual options, care would’ve been delayed and could’ve resulted in a worse cardiac event,” explains Dr. Siobhan Gray, Medical Director for VCR at Kaiser Permanente. “Even if it’s not a major health concern yet, the longer you wait, the more likely it is to become one1.”

Physically getting equipment to patients was the first hurdle. They’d occasionally shipped monitors in the past, but how would they scale that service in a sustainable way? They quickly switched to a type of monitor that is easier to mail and has limited shipping costs. Next, they took stock of all internal touchpoints that would be disrupted by this move to digital.  

“We have a complex system, so it’s all about communication. Every day we tweaked things: patient reminders, workflows, scheduling, etc…,” recalls Lori Werner, nurse and member of the Cardiac Rhythm Monitor team. “I think the key element was the team being willing to try new ways to keep the service going – from the primary care doctors to the care coordination staff to the clinics.”  

The scheduling department was retrained, technicians’ roles changed, customer service adapted to new requests and clinics collaborated closely with the Cardiac Rhythm Monitor team.

Spurred by necessity, the solution went from concept to reality in two short weeks. Without it, care could have been delayed, which, in certain circumstances, can increase the risk of a dangerous cardiac event.

“We wanted to find a way to help our members overcome any barriers, so they could get all of the appropriate cardiac testing needed despite the challenges of receiving care during the pandemic,” Dr. Gray says.

The virtual process looks like this: Patients receive a phone call informing them that their monitor is about to be shipped. When it arrives, patients are instructed to call a support number to get step-by-step instructions on setup and use. The patient wears the monitor for the designated amount of time, then sends it back in a prepaid box. A cardiologist reviews the report and holds a virtual appointment with the patient to go over results and next steps.

Though the program is new, initial results show that the completion rate of the virtual cardiac event monitoring program at Kaiser Permanente is comparable to the in-person completion rate, making it a viable option for patients beyond the current state we are in with COVID-19.

Propelled by client demand, operational efficiency and, in this case, necessity, Kaiser Permanente embraces the opportunities introduced by digital tools.

“We’ve been going more and more to virtual for a long time. This just pushed the envelope even further,” Werner says. “This experience has exceeded my expectations. I didn’t know if people would accept it, but it’s a paradigm shift. Many patients love it.”

As in-person care ramps back up, the Cardiac Rhythm Monitor team plans to explore hybrid care that combines the best of both models and expands patient options long after COVID-19.

[1]Falkers, Brittany. KGW8. Oregon’s first virtual cardiac rehab empowers patients after heart attacks. March 3, 2020. https://www.kgw.com/article/news/health/oregons-first-virtual-cardiac-rehab-empowers-patients-after-heart-attacks/283-a4543bfd-0d2c-43e2-a229-65fed5a00787


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