{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:23:43Z","timestamp":1788992623369,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>An unprecedented shift to remote heart failure outpatient care occurred during the coronavirus disease 2019 (COVID-19) pandemic. Given challenges inherent to remote care, we studied whether remote visits (video or telephone) were associated with different patient usage, clinician practice patterns, and outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We included all ambulatory cardiology visits for heart failure at a multisite health system from April 1, 2019, to December 31, 2019 (pre-COVID) or April 1, 2020, to December 31, 2020 (COVID era), resulting in 10\u2009591 pre-COVID in-person, 7775 COVID-era in-person, 1009 COVID-era video, and 2322 COVID-era telephone visits. We used multivariable logistic and Cox proportional hazards regressions with propensity weighting and patient clustering to study ordering practices and outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Compared with in-person visits, video visits were used more often by younger (mean 64.7 years [SD 14.5] versus 74.2 [14.1]), male (68.3% versus 61.4%), and privately insured (45.9% versus 28.9%) individuals (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05 for all). Remote visits were more frequently used by non-White patients (35.8% video, 37.0% telephone versus 33.2% in-person). During remote visits, clinicians were less likely to order diagnostic testing (odds ratio, 0.20 [0.18\u20130.22] video versus in-person, 0.18 [0.17\u20130.19] telephone versus in-person) or prescribe \u03b2-blockers (0.82 [0.68\u20130.99], 0.35 [0.26\u20130.47]), mineralocorticoid receptor antagonists (0.69 [0.50\u20130.96], 0.48 [0.35\u20130.66]), or loop diuretics (0.67 [0.53\u20130.85], 0.45 [0.37\u20130.55]). During telephone visits, clinicians were less likely to prescribe ACE (angiotensin-converting enzyme) inhibitor\/ARB (angiotensin receptor blockers)\/ARNIs (angiotensin receptor-neprilysin inhibitors; 0.54 [0.40\u20130.72]). Telephone visits but not video visits were associated with higher rates of 90-day mortality (1.82 [1.14\u20132.90]) and nonsignificant trends towards higher rates of 90-day heart failure emergency department visits (1.34 [0.97\u20131.86]) and hospitalizations (1.36 [0.98\u20131.89]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Remote visits for heart failure care were associated with reduced diagnostic testing and guideline-directed medical therapy prescription. Telephone but not video visits were associated with increased 90-day mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.121.008573","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T09:01:30Z","timestamp":1632992490000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Practice Patterns and Patient Outcomes After Widespread Adoption of Remote Heart Failure Care"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5782-7437","authenticated-orcid":true,"given":"Neal","family":"Yuan","sequence":"first","affiliation":[{"name":"Smidt Heart Institute (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"Botting","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaron","family":"Elad","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.), Cedars-Sinai Medical Center, Los Angeles, CA."},{"name":"Division of Informatics, Department of Biomedical Sciences (Y.E., S.J.M.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun J.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine (S.J.M.), Cedars-Sinai Medical Center, Los Angeles, CA."},{"name":"Division of Informatics, Department of Biomedical Sciences (Y.E., S.J.M.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4977-036X","authenticated-orcid":true,"given":"Susan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E.","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-2691","authenticated-orcid":true,"given":"Michelle M.","family":"Kittleson","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute (N.Y., P.G.B., Y.E., S.C., J.E.E., M.M.K.), Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2020.04.008"},{"key":"e_1_3_5_3_2","volume-title":"Early Impact Of CMS Expansion Of Medicare Telehealth During COVID-19 | Health Affairs","author":"Verma S","unstructured":"Verma, S. 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