Evidence map›Paper›PMID 33878021›Full record

ArticleJMIR cardio2021

The Resilience of Cardiac Care Through Virtualized Services During the COVID-19 Pandemic: Case Study of a Heart Function Clinic.

Amika Shah, Milena Guessi, Sahr Wali, Patrick Ware, Michael McDonald, Mary O'Sullivan, Juan Duero Posada, Heather Ross, Emily Seto

Open access · goldAbstract read
In one paragraph

Article in JMIR cardio, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Lessons Learned from the Lessons Learned in Public Health during the First Years of COVID-19 Pandemic.International journal of environmental research and public health · 2023
    Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 2 countries.

Amika Shah *Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-8615-2683
Milena Guessi *Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-1728-8384
Sahr WaliCentre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-1928-531X
Patrick WareCentre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-5325-9871
Michael McDonaldPeter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-8026-9274
Mary O'SullivanPeter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-6279-9319
Juan Duero PosadaTed Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0001-6118-4200
Heather RossPeter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-4384-3027
Emily SetoCentre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-8723-5915
University Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVirtual care has historically faced barriers to widespread adoption. However, the COVID-19 pandemic has necessitated the rapid adoption and expansion of virtual care technologies. Although the intense and prolonged nature of the COVID-19 pandemic has renewed people's interest in health systems resilience, which includes how services adapt or transform in response to shocks, evidence regarding the role of virtual care technologies in health systems resilience is scarce.

objectiveAt Toronto General Hospital in Ontario, Canada, the rapid virtualization of cardiac care began on March 9, 2020, as a response to the pandemic. The objective of this study was to understand people's experiences with and the barriers and facilitators of the rapid virtualization and expansion of cardiac care resulting from the pandemic.

methodsA single-case study was conducted with 3 embedded units of analysis. Patients, clinicians, and staff were recruited purposively from an existing mobile, phone-based telemonitoring program at a heart function clinic in Toronto, Canada. Individual, semistructured phone interviews were conducted by two researchers and transcribed verbatim. An inductive thematic analysis at the semantic level was used to analyze transcripts and develop themes.

resultsA total of 29 participants were interviewed, including patients (n=16), clinicians (n=9), and staff (n=4). The following five themes were identified: (1) patient safety as a catalyst for virtual care adoption; (2) piecemeal virtual care solutions; (3) confronting new roles and workloads; (4) missing pieces in virtual care; and (5) the inequity paradox. The motivation to protect patient safety and a piecemeal approach to virtual care adoption facilitated the absorptive and adaptive resilience of cardiac care during the COVID-19 pandemic. However, ad hoc changes to clinic roles and workflows, challenges in building relationships through remote methods, and widened inequities were barriers that threatened virtual care sustainment.

conclusionsWe contend that sustaining virtual care hinges upon transformative actions (rather than adaptive actions) that strengthen health systems so that they can face the dynamic and emergent challenges associated with COVID-19 and other shocks. Based on the barriers and facilitators we identified, we present the lessons we learned and recommend transformations for sustaining virtual care during and beyond the COVID-19 pandemic.

Indexed as

cardiologycoronavirusCOVID-19digital healthdigital medicineglobal healthinfectious diseaseorganizational innovationorganizational objectivesoutbreakpandemicpatientpublic healthresilienceSARS-CoV-2surveillancetelehealthtelemedicine

Identifiers

PMID33878021
PMCPMC8411433
OpenAlexW3154638832

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.