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Million Hearts Cardiac Rehabilitation Think Tank: Accelerating New Care Models
Circulation: Cardiovascular Quality and Outcomes ( IF 6.9 ) Pub Date : 2021-09-30 , DOI: 10.1161/circoutcomes.121.008215
Alexis L Beatty 1 , Todd M Brown 2 , Mollie Corbett 3 , Dean Diersing 4 , Steven J Keteyian 5 , Ana Mola 6 , Haley Stolp 7, 8 , Hilary K Wall 8 , Laurence S Sperling 8, 9
Affiliation  

This article describes the October 2020 proceedings of the Million Hearts Cardiac Rehabilitation Think Tank: Accelerating New Care Models, convened with representatives from professional organizations, cardiac rehabilitation (CR) programs, academic institutions, federal agencies, payers, and patient representative groups. As CR delivery evolves, terminology is evolving to reflect not where activities occur (eg, center, home) but how CR is delivered: in-person synchronous, synchronous with real-time audiovisual communication (virtual), or asynchronous (remote). Patients and CR staff may interact through ≥1 delivery modes. Though new models may change how CR is delivered and who can access CR, new models should not change what is delivered—a multidisciplinary program addressing CR core components. During the coronavirus disease 2019 (COVID-19) public health emergency, Medicare issued waivers to allow virtual CR; it is unclear whether these waivers will become permanent policy post-public health emergency. Given CR underuse and disparities in delivery, new models must equitably address patient and health system contributors to disparities. Strategies for implementing new CR care models address safety, exercise prescription, monitoring, and education. The available evidence supports the efficacy and safety of new CR care models. Still, additional research should study diverse populations, impact on patient-centered outcomes, effect on long-term outcomes and health care utilization, and implementation in diverse settings. CR is evolving to include in-person synchronous, virtual, and remote modes of delivery; there is significant enthusiasm for implementing new care models and learning how new care models can broaden access to CR, improve patient outcomes, and address health inequities.

中文翻译:

万心心脏康复智库:加速新护理模式

本文介绍了百万心脏心脏康复智囊团 2020 年 10 月的会议记录:加速新的护理模式,与来自专业组织、心脏康复 (CR) 计划、学术机构、联邦机构、付款人和患者代表团体的代表召集。随着 CR 交付的发展,术语也在不断演变,以反映活动发生的位置(例如,中心、家庭),而是反映 CR 的交付方式:面对面同步、与实时视听通信同步(虚拟)或异步(远程)。患者和 CR 工作人员可能通过≥1 种交付模式进行交互。尽管新模型可能会改变 CR 的交付方式以及谁可以访问 CR,但新模型不应改变交付的内容——解决 CR 核心组件的多学科计划。在 2019 年冠状病毒病 (COVID-19) 突发公共卫生事件期间,Medicare 发布了允许虚拟 CR 的豁免;目前尚不清楚这些豁免是否会成为突发公共卫生事件后的永久政策。鉴于 CR 使用不足和交付差异,新模型必须公平地解决患者和卫生系统对差异的贡献。实施新的 CR 护理模型的策略涉及安全、运动处方、监测和教育。现有证据支持新的 CR 护理模式的有效性和安全性。尽管如此,更多的研究应该研究不同的人群、对以患者为中心的结果的影响、对长期结果和医疗保健利用的影响,以及在不同环境中的实施。CR 正在发展以包括面对面同步、虚拟和远程交付模式;
更新日期:2021-10-20
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