Cardiovascular rehabilitation programs that include exercise and lifestyle coaching can reduce heart-related deaths by 25%. These programs can also prevent patients from returning to the hospital, yet studies show that more than 8 out of 10 people who are eligible for the programs don’t participate.
Patients say making expensive copays and having to leave work and travel long distances to a hospital or clinic prevent them from participating. So Kaiser Permanente developed a virtual cardiac rehab program (VCR) that requires no copays and allows patients to exercise wherever and whenever they choose.
Once enrolled, patients use a fitness tracker and smartphone app to record their exercise and heart rate. They upload their data to a secure site so a specially trained cardiac nurse can track their progress. The nurse checks in regularly with patients by phone to provide coaching and answer questions.
“Many of these patients didn’t exercise before they enrolled in the virtual cardiac rehab program. Now they have confidence in their own ability to improve their health,” said Heather Carey, RN, who leads case management for the program.
The 12-week program started last summer and has already enrolled more than 300 patients. Ninety percent of those patients complete the program, compared with only 13% of patients enrolled in clinic-based programs.
“We are seeing great improvements in exercise stamina, lowered blood pressure and other health benefits,” said Siobhan Gray, MD, VCR medical director, who is based at Kaiser Permanente’s Center for Heart and Vascular Care, the Northwest’s top-rated heart program, as rated by the Society of Thoracic Surgeons.
Dick Akins, a retired investment adviser from West Linn, is one of the patients seeing progress. He enrolled in the VCR program the week after his quadruple bypass surgery in October.
“Before the program, I intended to exercise, but I was always too busy. Now, I walk three miles a day, every day,” said Akins, who also keeps a paper log of his progress.
“Just like Tiger Woods relies on his golf coach, I rely on Heather’s coaching to keep me accountable.”
The program aims to prevent second heart attacks and cardiac events and to keep patients out of the hospital. Data on rehospitalization is not available yet for the Oregon program, but a similar program in California found that fewer than 2% of their patients returned to the hospital, compared with 10% to 15% nationally.
Once patients complete the 12-week program, they can opt to continue remote monitoring and check-ins for up to a year.
Most low-to moderate-risk heart patients are eligible for the VCR program. Examples include those recovering from a heart attack and those who’ve had bypass, stent or valve surgery. High-risk patients, including those who’ve had a heart transplant or who are at risk for falling, are referred to a center-based cardiac rehab program.