<div>Invited Editorial</div><div>Journal of Cardiac Surgery</div><div>Omar M Lattouf MD PHD FACC FACS</div><div>The article on the “Effectiveness of Telemedicine in a Mitral Valve
Center of Excellence” in the current issue of the Journal of Cardiac
Surgery by Irina Kolesnik, Sari D. Holmes, Rachael Quinn, Filomena
Koenigsberg, and James S. Gammie is a timely article that deserves the
attention of practicing cardiac surgeon as it provides much needed data
on the value, usefulness, patients and surgeons acceptance of the use of
tele-health as a new method of</div><div>clinical connectivity between patients and their surgeons without
compromising outcomes.</div><div>As said in layman’s terms, “Necessity is the Mother of Invention”,
tele-health became a much needed modality as Covid disrupted every
aspect of our lives including how medicine and surgery were practiced.
Covid became a very strong driver for the adoption of tele-health in a
matter of days after its explosive onset world wide.</div><div>Despite the fact that, historically and for several decades, there was
interest in tele-health, its application was extremely limited due to
multiple reasons including patient and physician lack of awareness and
none or extremely limited acceptance by Medicare, Medicaid and thirty
party payers.</div><div>The onset and the lingering of Covid with unknown end in sight, impacted
people’s mobility, social distancing, self-isolation, travel
restrictions and restrictions on in-person meeting, along with the fear
of disease transmission created unprecedented environments that impacted
the time-honored patient-physician in-person visits, consultations and
evaluation.</div><div>Despite these burdensome changes imposed by the social distancing,
patients continued to have illnesses that required advanced care,
continued to require evaluation for operative procedures and for those
patients who undergo the required procedures to have the much needed
post operative evaluation, assessment and care post-discharge.</div><div>Tele-health, out of great necessity, became of high interest and value
to healthcare providers, government agencies responsible for guiding the
health of the nation, as well as for technology companies and
entrepreneurs interested in new business opportunities. The confluence
of events and opportunities, the availability of tele-health
technologies and devices, and the pressing need to continue the needed
patient care resulted in rapid acceptance and utilization of telehealth
application almost overnight. New, user-friendly and innovative
tele-health techniques and devices became widespread. Institutions
across the globe started deploying tele-health as an acceptable
alternative to in-person meetings.</div><div>Thus, many institutions and physicians in different subspecialties
adopted the use of telehealth and were able to provide consultations and
remote care for their patients, despite national lockdowns and thus were
able to circumvent all the restrictions on mobility and in-person
contacts that became widespread across the globe.</div><div>A recent report by M Melchionna published in mHealth Intelligence
magazine on March 4, 2022 in a survey on 4300 patients indicated that
tele-health was adopted at surprisingly high rate reaching over 50% of
the patient-physician encounters during the height of the pandemic in
2020. Furthermore the patient satisfaction was high reaching 860 on a
1000-point scale.</div><div>Thus, even who were evaluated and underwent complex cardiac procedures
such as mitral valve repair or replacement, the perceived effectiveness
and acceptance by patients and surgeons was very impressive with 97% of
patients giving a very satisfied or satisfied grade and only 3% who
were unsatisfied. This high level of acceptance is inline with what is
reported above by Melchionna, thus giving further support to what our
surgical colleagues have stated in their article.</div><div>As a physician who has been interested in tele-health and tele-medicine
for the last forty years, I believe the time has come for tele-health
and digital health to take central role in many aspects of
patient-provider relations.</div><div>Cardiac surgeons would be served well to learn from the experience of
Dr. Kolesnik and colleagues. The time is now to examine and deploy
strategic steps to incorporate digital health into the practice of
cardiac surgery..</div>