Million Hearts Cardiac Rehabilitation Think Tank: Accelerating New Care Models

被引:29
|
作者
Beatty, Alexis L. [1 ]
Brown, Todd M. [2 ]
Corbett, Mollie [3 ]
Diersing, Dean [4 ]
Keteyian, Steven J. [5 ]
Mola, Ana [6 ]
Stolp, Haley [7 ,8 ]
Wall, Hilary K. [8 ]
Sperling, Laurence S. [8 ,9 ]
机构
[1] UCSF, Dept Epidemiol & Biostat, Med, Box 0560,550 16th St, San Francisco, CA 94143 USA
[2] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA
[3] Amer Assoc Cardiovasc & Pulm Rehabil, Chicago, IL USA
[4] UMC Hlth Syst, Phys Med & Rehabil, Lubbock, TX USA
[5] Henry Ford Med Grp, Div Cardiovasc Med, Detroit, MI USA
[6] NYU Langone Hlth, Dept Rehabil Med, New York, NY USA
[7] IHRC Inc, Atlanta, GA USA
[8] CDC, Atlanta, GA 30333 USA
[9] Emory Ctr Heart Dis Prevent, Atlanta, GA USA
来源
基金
美国国家卫生研究院;
关键词
cardiac rehabilitation; delivery of health care; patient-centered care; patient advocacy; public health; PULMONARY REHABILITATION; MYOCARDIAL-INFARCTION; AMERICAN-ASSOCIATION; PREVENTION PROGRAMS; PARTICIPATION; HOME; EXERCISE; INTENSITY; MEDICARE; FAILURE;
D O I
10.1161/CIRCOUTCOMES.121.008215
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This article describes the October 2020 proceedings of the Million Hearts Cardiac Rehabilitation Think Tank: Accelerating New Care Models, convened with representatives from professional organizations, cardiac rehabilitation (CR) programs, academic institutions, federal agencies, payers, and patient representative groups. As CR delivery evolves, terminology is evolving to reflect not where activities occur (eg, center, home) but how CR is delivered: in-person synchronous, synchronous with real-time audiovisual communication (virtual), or asynchronous (remote). Patients and CR staff may interact through >= 1 delivery modes. Though new models may change how CR is delivered and who can access CR, new models should not change what is delivered-a multidisciplinary program addressing CR core components. During the coronavirus disease 2019 (COVID-19) public health emergency, Medicare issued waivers to allow virtual CR; it is unclear whether these waivers will become permanent policy post-public health emergency. Given CR underuse and disparities in delivery, new models must equitably address patient and health system contributors to disparities. Strategies for implementing new CR care models address safety, exercise prescription, monitoring, and education. The available evidence supports the efficacy and safety of new CR care models. Still, additional research should study diverse populations, impact on patient-centered outcomes, effect on long-term outcomes and health care utilization, and implementation in diverse settings. CR is evolving to include in-person synchronous, virtual, and remote modes of delivery; there is significant enthusiasm for implementing new care models and learning how new care models can broaden access to CR, improve patient outcomes, and address health inequities.
引用
收藏
页码:1094 / 1103
页数:10
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