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A Doctor Visit Via Video? Let’s Check That Pacemaker or Defibrillator Incision

July 02, 2019

Download your guide on irregular heartbeats – and how they’re diagnosed and treated. 

It takes less than five minutes for Dr. Steven Zweibel or the APRNs in his electrophysiology office at the Hartford HealthCare Heart & Vascular Institute to check the incision made to install a pacemaker or implantable cardioverter-defibrillator (ICD) and ensure it is healing properly.

Normally, the incision is checked three to four weeks after the patient receives the device to regulate their heartbeat or a new battery in an existing device. Such a follow-up appointment – which checks that the device is working properly and the skin is healing nicely – has entailed a drive from the patient’s home to offices in either Hartford or West Hartford.

In late April, however, the office started offering a new option for the quick check – video visits.

“This was an excellent opportunity to use telehealth,” says Dr. Zweibel, director of electrophysiology for the Hartford HealthCare Heart & Vascular Institute. “Technology is now in a place where we can take advantage of it. It’s an alternative, more patient-centric way of delivering healthcare.”

After the surgical procedure, patients take home a remote monitor that connects wirelessly to the device and relays key information from it to the doctors.

“This is the perfect scenario to use telehealth,” he said. “Patients have the remote monitor and we can use the camera on their phone, tablet or computer to check their wound.”

While admitting there was “a little trepidation on all parts” when initiating the telehealth program for electrophysiology patients, Dr. Zweibel said he’s found that the stereotypes about older people not being interested in or able to use technology are unfounded. If a person does happen to be wary of the application, he added that there’s always a technically savvy child or grandchild who is willing to help.

As for his office team, they’re enjoying hosting video visits, after overcoming some initial trepidation over the technology.

“I experienced a bit of fear of the unknown. In addition, I felt a bit overwhelmed with the prospect of not only fulfilling the role of the clinician conducting the visit but also potentially as the tech support resource if the patient experienced connection difficulties such as trouble hearing or seeing me during the visit,” said Carolyn Tschummi, APRN. “But, it is very rewarding to connect with patients in their own home environment; they are often surrounded by family members and pets, which allows them to feel more relaxed and comfortable during the visits.”

Patients, Tschummi added, are “excited and grateful” to use the technology for visits from their homes.

“Surprisingly, those who are comfortable and excited about the prospect of conducting a visit virtually span many different age groups. In fact, my first patient was in his early 80s!” she said. “The virtual visits are quicker than an in-person visit and the quality of care provided is equal.”

Dr. Zweibel also said he’s thinking of other ways in which telehealth can improve the patient experience. Patients living in eastern Connecticut or Rhode Island, for example, may not have to drive an hour or more for a visit with an electrophysiologist but might simply be able to go to their provider’s office and experience a virtual consultation visit from there.

“This technology is not site-specific,” he noted. “Dr. (Paras) Bhatt at Backus does device implants. What if we have one APRN in Hartford who checks all the wounds on my patients, Dr. Bhatt’s patients, and those of other providers?”

Video visits are a form of telehealth, which Hartford HealthCare has been introducing in different service lines since September 2018 when the Headache Center launched a pilot. Visits can be conducted via a home computer, mobile phone or tablet using MyChart Plus, the system’s electronic medical record platform.

On video visits, patients can interact with their provider, ask questions and chat real-time as they would in a traditional appointment. Providers have the medical record open and can order prescriptions, send referrals for testing and schedule new appointments.

The technology, according to Dr. Zweibel, helps providers best “use the resources we have” and frees up staff for patients with more urgent issues and new patients who need to be seen in person.

“This technology is improving the patient and provider experience,” he noted.

In addition, telehealth also promises to: keep patients out of the emergency department; lower costs; expand care across state lines; increase patient access to specialists; and decrease same-day cancellations due to illness or weather.

Download your guide on irregular heartbeats – and how they’re diagnosed and treated. 

To be eligible for telehealth appointments, patients must have a free MyChart Plus account using an activation code obtained from the provider’s office or by calling the support line at 860.972.4993.