Purpose: 

This review describes the considerations for the design and implementation of a hybrid cardiac rehabilitation (HYCR) program, a patient-individualized combination of facility-based cardiac rehabilitation (FBCR) with virtual cardiac rehabilitation (CR) and/or remote CR.

Review Methods: 

To help meet the goal of the Millions Hearts Initiative to increase CR participation to 70% by 2022, a targeted review of the literature was conducted to identify studies pertinent to the practical design and implementation of an HYCR program. Areas focused upon included the current use of HYCR, exercise programming considerations (eligibility and safety, exercise prescription, and patient monitoring), program assessments and outcomes, patient education, step-by-step instructions for billing and insurance reimbursement, patient and provider engagement strategies, and special considerations.

Summary: 

A FBCR is the first choice for patient participation in CR, as it is supported by an extensive evidence base demonstrating effectiveness in decreasing cardiac and overall mortality, as well as improving functional capacity and quality of life. However, to attain the CR participation rate goal of 70% set by the Million Hearts Initiative, CR programming will need to be expanded beyond the confines of FBCR. In particular, HYCR programs will be necessary to supplement FBCR and will be particularly useful for the many patients with geographic or work-related barriers to participation in an FBCR program. Research is ongoing and needed to develop optimal programming for HYCR.

中文翻译：

---

混合心脏康复计划的设计和实施回顾：优化心血管护理的扩大机会

目的： 

本综述描述了混合心脏康复 (HYCR) 计划的设计和实施考虑因素，该计划是基于设施的心脏康复 (FBCR) 与虚拟心脏康复 (CR) 和/或远程 CR 的患者个性化组合。

审核方法： 

为了帮助实现“百万爱心计划”的目标，即到 2022 年将 CR 参与率提高到 70%，我们对文献进行了有针对性的审查，以确定与 HYCR 计划的实际设计和实施相关的研究。重点关注的领域包括 HYCR 的当前使用、运动计划注意事项（资格和安全、运动处方和患者监测）、计划评估和结果、患者教育、计费和保险报销的分步说明、患者和提供者参与策略和特殊考虑。

概括： 

FBCR 是患者参与 CR 的首选，因为它得到了广泛的证据基础的支持，证明它可以有效降低心脏死亡率和总体死亡率，以及改善功能能力和生活质量。然而，为了实现百万爱心计划设定的 70% 的 CR 参与率目标，CR 项目需要扩展到 FBCR 的范围之外。特别是，HYCR 计划对于补充 FBCR 是必要的，并且对于许多因地理或工作相关障碍而无法参与 FBCR 计划的患者特别有用。研究正在进行中，需要为 HYCR 开发最佳编程。