Clinical Services

ePoster Presentation

(EP-104) Cardiology Telehealth Utilization for Improving Timing of Diagnosis, Compliance, Treatment and Satisfaction

Monday, April 24
9:45 AM - 10:00 AM
Location: Experience Zone - ePosters

Evaluating the implementation of telehealth technology in an outpatient cardiovascular clinic utilizing Facetime or GoToMeeting to increase access to cardiology care, reduce delay in evaluation of symptoms, diagnosis, and treatment. This is a pilot project aimed to address the need for improving cardiovascular care as one out of every three deaths in the United States is attributable to cardiovascular disease. Measurements to improve patient satisfaction, reduce PCP or ED return visits, timing of testing, timing of diagnosis, timing of intervention, and decrease no show rate for new patient appointments are targets addressed in this study. It is expected that patients who were assessed using telehealth prior to in-person consultation have improvement in the timing of testing with results, diagnosis, treatment, intervention, appointment compliance, and overall satisfaction with the practice.

This study is based on a hypothesis of difference using the quasi-experimental design. Inclusion criteria mandates the patient is 18-75 years of age, referred from primary care or emergency department with symptoms of chest discomfort, shortness of breath, dizziness or arrhythmia. Patients are evaluated for 12 weeks tracking their progress through an outpatient cardiology clinic. The experimental group will have a telehealth visit performed by a cardiology nurse practitioner within 72 hours of referral for symptoms suggestive of heart disease. Orders will be placed for diagnostic evaluation and testing ideally performed prior to on-site consultation. Control group patients will have their initial provider contact at the first in-person consultation. The independent variable is exposure to telehealth consultation. The dependent variables are timing of diagnostic testing, diagnosis, initiation of treatment, number of recurrent cardiology clinic no-shows, recurrent cardiac related visits to the PCP or ED, satisfaction and additional telehealth needs.

The study is pending final IRB approval by Old Dominion University at this time. It is expected to launch the last week of September 2016 with final data collection of the last entry of patients by February. The PI plans to have finalization of all data points and results by February 28th 2017.

It is expected at the conclusion of the study that patients who were evaluated by telehealth technology prior to on-site consultation will have a significant improvement in the time it takes from symptoms onset to evaluation, diagnosis and treatment. The intention of this study to show patient satisfaction increases as their symptoms and concerns are addressed in a more timely manner. It is expected that the rate of no-show appointment will be reduced as patient are engaged sooner then conventional methods and more likley to have compliance with evaluation and treatment. . This study is also positioned to show a reduction in return visits to the referring primary care practice or emergency department when patients are engaged early on with telehealth potentially saving the health care system substantial money and improving resource allocation.

Marc Arnold

Adult Nurse Practitioner and Doctor of Nursing Practice Student
Employer: Bon Secours Health System , Program: Old Dominion University

Marc Arnold is a highly skilled nurse practitioner in the field of cardiology and emergency medicine pursuing his doctoral degree in nursing practice. Combining 18 years of nursing practice, 24 year history in fire/emergency medical service and passion for technology driven health care, he has dedicated his doctoral research to telemedicine. Graduating with honors from Adelphi University with a bachelor’s of nursing degree then a master’s degree from Stony Brook University with honors as an adult nurse practitioner, has set the foundation for his commitment to patient care.
His career started in critical care nursing at Cornell Medical Center providing care to patient’s post-operative open heart and thoracic surgery. His career moved onto combining his emergency medicine interest and critical care skills accepting a position as a trauma nurse at Winthrop University Hospital, New York. He served as a charge position, trauma, critical care and pediatric emergency nurse while continuing to study for his nurse practitioner degree.
As a new nurse practitioner graduate, he worked in a network of primary care practices located in New York then focused on his passion for cardiology accepting a position in Richmond Virginia in 2005.
Serving as a cardiology and emergency medicine nurse practitioner, Marc decided it was time to take his experience, interest in alternative delivery of patient care and passion for evolving technologies and use these tools for problem solving the health care crisis. His capstone project is a pilot study dedicated to the advancement of patient care in cardiovascular medicine. Seeing the need to expedite patient evaluation while facing the strain of limited time and availability to provide patient care, he has developed a program using cost effective and HIPAA compliant video platform to consult on patients with suspected cardiovascular conditions prior to an in-person evaluation.


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Margaret J. Constante

Doctor of Nursing Practice, Family Nurse Practitioner
Old Dominion University, Commonwealth Dermatology

Margaret (Maggie) Constante grew up in Virginia Beach, Virginia, where she resided for 28 years. She earned her Associates and Bachelors degree in Science of Nursing from Norfolk State University. With the desire to become a nurse practitioner, she moved to Richmond and worked as a registered nurse in surgery-trauma at the Medical College of Virginia Hospital. In 2004 she graduated from Virginia Commonwealth University with a Masters of Science of Nursing degree and became a board-certified Family Nurse Practitioner. Later that year, she became Commonwealth Dermatology’s first Nurse Practitioner. In 2014, she graduated from Old Dominion University with a Doctor of Nursing Practice.
Dr. Constante is the recipient of many awards and honors including Summa Cum Laude from Norfolk State University, Excellence in Preceptor Award while working at MCV, Sigma Theta Tau member since 2003, and she earned the highest GPA of the doctoral candidates in the College of Health Sciences at ODU and carried the Doctorate banner during the commencement ceremony.
Dr. Constante is a nursing leader, educator, speaker and researcher. Her Capstone, Parental Empowerment Program for Children with Atopic Dermatitis: Interventions Utilizing Telehealth, was presented at the Virginia Council of Nurse Practitioner’s Annual Conference and the ODU Graduate Research Achievement Day in 2014.
She currently works at Commonwealth Dermatology and her passion is to advance nursing as a profession and to improve access to dermatology care for Virginians.


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(EP-104) Cardiology Telehealth Utilization for Improving Timing of Diagnosis, Compliance, Treatment and Satisfaction

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