Philips : World Heart Day 2021

A. Dr. Olivia Gilbert: Electronic health records are a wonderful source for equalizing access to healthcare by engaging patients at a personalized level. And if they have the ability to interconnect, EMRs can also address the fragmentation of healthcare by allowing medical providers to see what's being done by other health systems. This interoperability among electronic healthcare records is also key to reducing waste and increasing efficiency. There is a big opportunity for digital health to improve care, increase efficiencies, and reduce costs.

Q. Dr. Jennifer Franke: When the COVID-19 pandemic hit, a lot of non-acute care stopped or was delayed. What was your experience as clinicians and how did you adapt your patient care?

A. Dr. Olivia Gilbert: As a heart failure care provider, I have different categories of patients - general heart failure patients, left ventricular assist device (LVAD) patients with a mechanical pump in their heart, and heart transplant patients. For the general heart failure patients, we were able to employ telehealth to engage them and remotely monitor cardiac devices such as defibrillator and pulmonary artery pressure monitoring implants. But with the LVAD and transplant patients, the show kind of had to go on regardless of COVID-19. So there were categories of patients for which we were able to employ different mechanisms, but there were also certain populations where we had to carry on as normal to the best of our ability.

A. Dr. Magnus T. Jensen: The COVID pandemic has been a profound experience for all of us both on a professional level as well as a personal level. While we were in lockdown, we shut down most non-acute patient care. Before COVID, I don't think there was ever a time when we closed the ambulatory clinics, but now we've not only done it once, we've done it twice. It's been quite challenging not only for patients but also for the staff, doctors and management.

We know that the patients we normally follow in our ambulatory clinics, where they may not be acute, can very easily become acute patients. So you can't just shut down a cardiology clinic. You have to implement emergency procedures and clinics. The first thing we did was triage all our patients into a green, yellow or red category, with the red category being the ones we expected to become acute patients within a few days or weeks. Then we had to set up emergency clinics and put a structure in place to support them, which would have been very difficult had it not been for digital technology. We now support device integration, which means people can self-measure their blood pressure and weight, and wear a smart watch at home that transmits data via Bluetooth to their mobile phone and back to our EMR. It means that if we have another wave of COVID-19 and we need to shut down our clinics again, we will be much better equipped. And that's due to technology and innovation.

Q. Dr. Jennifer Franke: When building a more resilient healthcare system post COVID, which adaptive measures do you think will stick and what still needs to change?

A. Dr. Olivia Gilbert: I think that telehealth is here to stay, so the next step is understanding which populations will most benefit from it and in what settings. In fact, I have just submitted a grant application to study outcomes in specific cardiac populations to ascertain which circumstances telehealth works best, looking at the outcomes associated with telehealth versus non-telehealth care in specific subgroups of cardiac patients.