Abstract
Prevention and risk factor management are key in slowing heart disease progression. Cardiac rehabilitation is a proven evidence-based secondary prevention program that enhances quality of life, decreases morbidity and mortality, and reduces hospital readmissions following a cardiac event. Underutilization of cardiac rehabilitation for eligible participants has been a long-standing challenge. Home-based cardiac rehabilitation has potential to improve access to patients, adherence, reduce travel time and decrease transportation costs. COVID-19 provided a window of opportunity for home-based cardiac rehabilitation with CMS authorizing cardiac rehab for telehealth services for the first time. This presentation discusses the barriers experienced when developing a home-based cardiac rehabilitation platform. The barriers are divided into two sections: those specific to the center-based cardiac rehabilitation site and those pertinent to the patient. The site-specific barriers included decreased staff, fewer referrals, and lack of stakeholder support. The barriers applicable to the patient included difficulty with technology, Zoom fatigue, desire to participate in-person with other individuals and high risk conditions including frequent falls, severely reduced ejection fraction and memory impairment. Solutions to the barriers included expanding the recruitment process to multiple sites, and having referrals contacted by consistent coordinator to help determine patient interest. Expanding to a group virtual platform are future considerations for home-based cardiac rehabilitation.