P015. Implementing Telemedicine Practices for Mechanical Circulatory Support Patients During COVID-19 Global Pandemic

OBJECTIVE: To provide safe, comprehensive, medical care to homebound MCS patients during the COVID-19 global pandemic. BACKGROUND: The first case of COVID-19 was diagnosed in New Jersey on March 2, 2020. Eight days later the first death from the virus occurred. With cases rapidly increasing, the statewide stay at home order came shortly after on March 21, 2020, closing down all non-essential businesses and non-urgent travel. Hospitals became COVID only and the majority of non-emergent medical cases were discharged home. MCS patients, who were used to being seen in clinic on a monthly basis, were suddenly required to adapt to a new care model. The team of MCS coordinators collaborated and were able to provide continuous, safe, medical care remotely to this complex population by utilizing telemedicine and home diagnostic services; a novel change in practice. METHODS: • Initiation of telemedicine platform for routine "visits" • Referral of all patients to mobile lab services for blood work and/or administration of home INR monitoring equipment • Utilization of mobile radiology for remote x-rays, CT scans, and ultrasounds • Patients given Doppler and blood pressure cuff with instructions for home use RESULTS: The team completed a total of 81 telemedicine visits in 4 months, averaging 20 visits/month. There was 100% compliance with visits. Providers worked around the patients' schedules, completing visits outside of regular business hours. Our average monthly visits prior to COVID were around 30 visits/month, with 25% no show/cancellation rate. The MCS team was able to increase our compliance with weekly lab reporting from April (60%) to July (93%). Patients stated that they like the option of telemedicine and are more comfortable in their home setting during visits. The coordinators also like the ability to see patients in their home environment and the ability to observe return demonstration of dressing change at follow up intervals via video conferencing. CONCLUSION: Telemedicine and home monitoring have come a long way in the past few months, and can most definitely be used effectively in the MCS population. We observed an increase in adherence with treatment and an overall satisfaction in care received when patients were able to take an active role in their care, in their home, and at their preferred time of day. This study supports a change in practice to incorporate telemedicine into the routine care of the MCS population. We hope this will continue to increase patient satisfaction and decrease time patients spend in the hospital, which will increase quality of life.