{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T13:19:10Z","timestamp":1761311950084,"version":"3.41.2"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,2,21]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The COVID\u201019 pandemic forced Veterans Health Administration facilities to rapidly adopt and deploy telehealth alternatives to provide continuity of care to veterans while minimizing physical contact. The impact of moving to virtual visits on patients with congestive heart failure (HF) is unknown. The goal of this study was to understand how patients with HF and their providers experienced the shift to telehealth for managing a chronic condition, and to inform best practices for continued telehealth use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We identified Veterans Health Administration Medical Centers with high telehealth use before COVID\u201019 and sites that were forced to adopt telehealth in response to COVID\u201019, and interviewed cardiology providers and veterans with HF about their experiences using telehealth. Interviews were recorded, transcribed, and analyzed using team\u2010based rapid content analysis. We identified 3 trajectory patterns for cardiology telehealth use before and during COVID\u201019. They were the low\u2010use class (low to low), high\u2010use class (relatively high to higher), and increased\u2010use class (low to high). The high\u2010use and increased\u2010use classes fit the criteria for sites that had high telehealth use before COVID\u201019 and sites that rapidly adopted telehealth in response to COVID\u201019. There were 12 sites in the high\u2010use class and 4 sites in the increased\u2010use class. To match with the number of sites in the increased\u2010use class, we selected the top 4 sites by looking at the months before COVID\u201019. We identified 3 themes related to telehealth use among patients with HF and cardiology providers: (1) technology was the primary barrier for both patients and providers; (2) infrastructural support was the primary facilitator for providers; and (3) both patients and providers had largely neutral opinions on how telehealth compares to in\u2010person care but described situations in which telehealth is not appropriate.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Only 12 sites fit the criteria of high telehealth use in cardiology before COVID\u201019, and 4 fit the criteria of low use that increased in response to COVID\u201019. Patients and providers at both site types were largely satisfied using telehealth to manage HF. Understanding best practices for managing ambulatory care\u2013sensitive conditions through virtual visits can help the Veterans Health Administration prepare for long\u2010term impacts of COVID\u201019 on in\u2010person visits, as well as improve access to care for veterans who live remotely or who have difficulty traveling to in\u2010person appointments.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.027362","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T11:46:43Z","timestamp":1675856803000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Informing Use of Telehealth for Managing Chronic Conditions: Mixed\u2010Methods Evaluation of Telehealth Use to Manage Heart Failure During COVID\u201019"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-4658","authenticated-orcid":false,"given":"Chelsea","family":"Leonard","sequence":"first","affiliation":[{"name":"Denver Seattle Center of Innovation (COIN) Aurora Colorado"},{"name":"Division of Health Care Policy and Research University of Colorado Medical Campus Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhui","family":"Liu","sequence":"additional","affiliation":[{"name":"Denver Seattle Center of Innovation (COIN) Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8150-8820","authenticated-orcid":false,"given":"Ariel","family":"Holstein","sequence":"additional","affiliation":[{"name":"Denver Seattle Center of Innovation (COIN) Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1290-8422","authenticated-orcid":false,"given":"Slande","family":"Alliance","sequence":"additional","affiliation":[{"name":"Malcom Randall VA Medical Center Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Nunnery","sequence":"additional","affiliation":[{"name":"Denver Seattle Center of Innovation (COIN) Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2902-1836","authenticated-orcid":false,"given":"Carly","family":"Rohs","sequence":"additional","affiliation":[{"name":"Denver Seattle Center of Innovation (COIN) Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-7750","authenticated-orcid":false,"given":"Marilyn","family":"Sloan","sequence":"additional","affiliation":[{"name":"Denver Seattle Center of Innovation (COIN) Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5224-2891","authenticated-orcid":false,"given":"David E.","family":"Winchester","sequence":"additional","affiliation":[{"name":"Malcom Randall VA Medical Center Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252441"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.9972"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31356-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcaa055"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.038"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.10.074"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/00015385.2020.1787636"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2020.04.008"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-020-02299-z"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa156"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.31640"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.2671"},{"key":"e_1_3_2_14_2","first-page":"401","volume-title":"Foundations of mixed methods research: integrating quantitative and qualitative approaches in the social and behavioral sciences","author":"Teddlie C","year":"2009","unstructured":"Teddlie C, Tashakkori A. 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Virtual care for the longitudinal management of chronic conditions: a systematic review. 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