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VPExam and virtual care: Exploring the frontiers of novel digital tools

Nischay Shah, Anthony Annam, Nickolas Cireddu, James V. Cireddu

Telehealth is a growing field of importance, but the loss of comprehensive physical exam data creates barriers to managing complex heart failure patients. Innovative digital tools such as VPExam Virtual Care combine augmented reality guidance of video acquisitions with Bluetooth stethoscopes and single lead ECG to improve diagnostic accuracy by assessing volume status, cardiopulmonary auscultation, detection of arrythmias, and providing structured data including vitals, medication reconciliation, and labs. VPExam intervention has been shown to significantly improve the outcomes of high-risk heart failure patients discharged to Skilled Nursing Facilities and Home Care. VPExam QI revealed timely reliable cardiology consultation for follow up of heart failure hospitalization and urgent consultations created moderate significance modification in clinical management in 84% of encounters, while being associated with a 40% relative risk reduction in 30-day hospital readmission rate and a 56% relative risk reduction in 30-day mortality rate. This review summarizes challenges to cardiac transitions of care as well as the evolution of cardiac virtual care with actionable physical exam data to reduce readmissions and mortality.