Enhancing patient outcomes: Integrating electronic cardiology consultation in primary care for cancer patients

Eur J Clin Invest. 2024 Aug;54(8):e14197. doi: 10.1111/eci.14197. Epub 2024 Mar 22.

Abstract

Background: The prevalence of cancer patients with concomitant cardiovascular (CV) disease is on the rise due to improved cancer prognoses. The aim of this study is to evaluate the long-term outcomes of cancer patients referred to a cardiology department (CD) via primary care using e-consultation.

Methods: We analysed data from cancer patients with prior referrals to a CD between 2010 and 2021 (n = 6889) and compared two care models: traditional in-person consultations and e-consultations. In e-consultation model, cardiologists reviewed electronic health records (e-consultation) to determine whether the demand could be addressed remotely or necessitated an in-person consultation. We used an interrupted time series regression model to assess outcomes during the two periods: (1) time to cardiology consultation, (2) rates of all-cause and CV related hospital admissions and (3) rates of all-cause and CV-related mortality within the first year after the initial consultation or e-consultation at the CD.

Results: Introduction of e-consultation for cancer patients referred to cardiology care led to a 51.8% reduction (95%CI: 51.7%-51.9%) in waiting times. Furthermore, we observed decreased 1-year incidence rates, with incidence rate ratios (iRRs) [IC95%] of .75 [.73-.77] for CV-related hospitalizations, .43 [.42-.44] for all-cause hospitalizations, and .87 [.86-.88] for all-cause mortality.

Conclusions: Compared to traditional in-person consultations, an outpatient care program incorporating e-consultation for cancer patients significantly reduced waiting times for cardiology care and demonstrated safety, associated with lower rates of hospital admissions.

Keywords: cancer; cardiovascular outcomes; cardio‐oncology care; inter‐clinician electronic consultation.

MeSH terms

  • Aged
  • Cardiology
  • Cardiology Service, Hospital / organization & administration
  • Cardiovascular Diseases* / epidemiology
  • Electronic Health Records
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Interrupted Time Series Analysis
  • Male
  • Middle Aged
  • Neoplasms* / epidemiology
  • Neoplasms* / therapy
  • Primary Health Care*
  • Referral and Consultation*
  • Remote Consultation
  • Telemedicine
  • Waiting Lists