A total of 285 physicians/surgeons were surveyed between August 13, 2020 to September 7, 2020. Of these, 100 respondents identified as Cardiologists, 96 as another specialty and 89 as generalists (Internal Medicine, Family Medicine or Pediatrics – no sub specialty). Respondents had to be currently practicing with at least 10% of their primary responsibilities dedicated to direct patient care/interactions in order to qualify.

Additionally, approximately 150 completes were collected from three major metropolitan areas: Boston, Chicago and San Francisco (50+ completes each). All remaining completes were collected via random sampling of remaining U.S. geographies.

KEY FINDING 1: Faced with incredible uncertainty, providers are taking each day one at a time.

Many providers say they are feeling 'blindsided' by the recent pandemic, both in terms of the public health response and operational impacts. There is a renewed emphasis on the importance of disaster planning and preparation, but the key takeaway for most is learning how to be flexible and adapt to new information and challenges that each day brings during a pandemic.

Greatest Takeaways/Learning from the Pandemic (open-ended themes/coded responses)
Greatest Takeaways/Learning from the Pandemic (open-ended themes/coded responses)

KEY FINDING 2: Providers express concern over the impact on pre-existing conditions.

The majority of Cardiologists and non-Cardiologists alike are concerned that we have yet to see the full extent of COVID's impact on cardiac health.

  • Approximately 50% of providers are concerned that those who have survived the virus will still have worse cardiac health in the long-term.
  • 3 in 4 Cardiologists are worried that the pandemic has restricted current Heart Failure patients' ability to manage their condition.
  • 89% of Cardiologists have had to delay or restrict elective procedures—19% explicitly for transplants

More than half (55%) of Cardiologists are concerned about Heart Failure developing at an increasing rate among other patient populations due to COVID-19. They cited the following at-risk populations specifically:

  • Pre-existing/chronic conditions (45%)
    (including obesity and diabetes)
  • Adults aged 65+ (44%)
  • Black/African American (26%)
  • Low income (20%)

KEY FINDING 3: Short-term focus on rallying forces to meet increased cases/demand.

In anticipation of potential increased demand, 55% of Cardiologists say that resuming/scheduling elective procedures is a top priority through the latter half of 2020.

Virtual care is front and center in that equation.

  • Overall, 44% of providers plan to adapt/expand their virtual care capabilities heading into 2021.
  • 3 in 4 Cardiologists are worried that the pandemic has restricted current Heart Failure patients' ability to manage their condition.
  • 81% of providers saw an increase in virtual visits within the three to four months following the pandemic's onset in the U.S. as compared to 2019. On average, providers went from less than 10% of visits to nearly 40% of visits being virtual in this time.
  • Providers still generally expect at least a quarter to a third of their patient visits will remain virtual into 2021 and beyond.

But greater technology has not yet translated to greater efficiency.

  • Only 1 in 5 providers who increased their virtual visits were able to also increase their patient volumes/cases as a direct result.
  • In fact, 41% of providers who moved towards more virtual care said their patient volumes decreased.

KEY FINDING 4: Remote monitoring and treatment features prominently in next gen tech.

Half of providers (51%) indicated a strong desire to be able to remotely administer treatment or otherwise intervene when there is a potential issue with a patient.

  • 40% of providers would also like to see greater expansion of real-time, 24/7 monitoring capabilities over patient biometrics, to help predict when such intervention may be necessary in lieu of formal visits

Remote diagnostics and treatment are the next big step in successfully transitioning care out of the clinical setting and into a remote environment.

  • But there are expected to be some growing pains: in general, only 1 in 5 providers have experience leveraging remote monitoring devices with their complex care patients.

However, generalists and other specialists may be able to take their cues from Cardiology, which has greater adoption of remote monitoring over the past few decades.

  • 58% of Cardiologists have had direct experience using remote monitoring devices.
  • But Cardiologists are also significantly more likely to indicate remote monitoring capabilities need improvement for next gen. In particular, comfort/convenience for patients (35%), improved accuracy/precision of metrics (33%), increased integration with apps or other devices (29%) and anomaly detection/alerting (25%).

KEY FINDING 5: Incorporating remote monitoring into care is expected to boom post COVID.

Majority of Cardiologists believe that remote monitoring among complex care patients would help enable a more proactive care approach and improve overall outcomes through early detection/mitigation (67% & 68%).

  • Remote monitoring is also seen as helping empower patients to be more involved in managing their care (58%), which is a key concern Cardiologists have coming out of the pandemic.
  • Additionally, remote monitoring can minimize the frequency of required in-person care (47%) and reduce the risk of hospitalization or emergency care (65%)— ultimately protecting Heart Failure patients from potential exposure while helping Cardiologists manage their case loads.

79% of Cardiologists are interested in further incorporating their use of remote monitoring devices among patients.

  • But over half of non-Cardiologists are also interested in increasing their use of remote monitoring devices (55%) for the foreseeable, especially among Generalists.

One in three Cardiologists see remote monitoring as aiding in collaboration/workflow across care teams.

  • And overall, this aligns with a relatively high demand that technology is developed with collaboration/sharing capabilities in mind (40%).

KEY FINDING 6: Insurers and patients play a key role in bringing remote monitoring forward.

Coverage/insurance for remote monitoring devices is seen as a key barrier to wide adoption by the majority of both Cardiologists and non-Cardiologists. But COVID may bring changes here, too; the pandemic has encouraged many insurers to expand their virtual care coverage.

  • 59% of cardiologists, 60% of Generalists and 51% of other specialists listed coverage/reimbursement as the greatest barrier to adoption.

This leaves technology and relative familiarity as secondary barriers. 40% of Cardiologists say many remote monitoring devices are not reliable enough to provide value. Meanwhile, non-Cardiologists, especially Generalists, acknowledge there is a lack of familiarity with remote monitoring devices, both for patients and their own limited familiarity.

  • 41% of Cardiologists, 64% of Generalists and 47% of other specialists listed the lack of familiarity among patients as the greatest barrier to adoption
  • 36% of Cardiologists, 51% of Generalists and 32% of other specialists listed the lack of familiarity among clinicians as the greatest barrier to adoption

But for Heart Failure patients and those with other complex care conditions, that care may look different than what they're used to:

  • 75% of providers say their organization will encourage complex care patients to use virtual/remote care as much as possible.
  • In particular, 61% of Cardiologists say they will try to explore alternative treatment options to delay or reduce the need for in-person treatments.

KEY FINDING 7: Providers' recommendation for patients through COVID: you have control over your health.

35% of Cardiologists say Heart Failure patients are at a greater particular risk of COVID complications.

  • Both Cardiologists and non-Cardiologists believe that COVID-19 poses a greater risk to CHF patients over Cancer patients (any type).

But patients with respiratory conditions, diabetes and/or obesity are also believed to have significant risk—not just from COVID itself, but from developing further conditions.

  • Over half of Cardiologists indicate that they are very concerned about increased rates of Heart Failure developing in certain populations, primarily those with other pre-existing conditions.

There are steps that patients with ongoing care needs can take to still manage their condition while minimizing their risk/exposure to COVID, but it may require them to take an even more proactive role over their health.

  • 62% of providers encourage patients to maintain open dialogue/contact with their care team, even in the absence of in-person visits.
  • Specifically, one in every two Cardiologists advocate for patients to consider how remote monitoring devices/wearables could help them self-manage their condition (47%).

KEY FINDING 8: Remote technologies are poised to be the new clinical trial.

The lack of knowledge or information around COVID-19's full impact on cardiac health or outcomes is a top concern shared by both Cardiologists and non-Cardiologists alike.

  • And while Cardiologists are optimistic that the pandemic could spark renewed interest or funding for CHF research, many question the efficacy of gathering these insights.
  • Many anticipate that delays in treatment and limited enrollment over exposure/process concerns means that this research will hinder this critical research.

But that doesn't mitigate the need, as 61% of Cardiologists show a strong desire for research on the link/impact between COVID-19 and CHF.

  • Additionally, 36% of Cardiologists would also find value in research on the link between CHF and other comorbidities, such as T2 Diabetes-- research that could become increasingly critical if CHF rates rise in complex care populations (a very real concern, as cited by 45% of Cardiologists).

To meet this need, Cardiologists are turning towards remote monitoring and treatment solutions to gather data while also delivering care.

  • Half of Cardiologists indicated that they would find value in resources/best practices around how to effectively leverage remote care for CHF cases.
  • More specifically, 52% of Cardiologists would like more information on available virtual/remote monitoring solutions for patients.

KEY FINDING 9: Cardiologists are worried that certain patients will be left behind during COVID.

Nearly 2 in 3 Cardiologists say they are concerned about certain patients' ability to access CV care when needed, citing populations that have traditionally experienced health inequities: low income, the elderly and BIPOC/minorities.

  • In particular, 1 in 4 Cardiologists are very concerned the Black/African American population could experience increased rates of CHF as a direct result of COVID-19.
  • 64% of Cardiologists would also like to see virtual/remote care technology expand connection/coverage, especially among those with weaker access to internet such as low income or rural populations.
  • 61% would also like to see improvements in the simplicity of user interfaces, potentially to help on-board less tech-savvy populations.

Overall, providers do not expect to address disparities alone.

  • 2 in 5 Cardiologists believe the responsibility of addressing disparities falls to health care insurers.
  • 59% of Cardiologists see coverage/costs as a key barrier for greater adoption of remote monitoring devices and technology, which the majority of Cardiologists associate with key benefits aimed at improving CV outcomes.


San Francisco and Boston show greater adoption/affinity towards virtual care, while Chicago has been weaker.

  • San Francisco embraced virtual care with nearly half of all visits switching over to virtual in recent months. Boston showed a higher relative share/usage of virtual compared to national. But Chicago has had weaker adoption of virtual care. These trends are expected to persist through 2021.
  • This trend is reversed when it comes to remote monitoring, where San Francisco providers -- both non-Cardio and Cardiologists-- are less likely to have prior experience with remote monitoring devices. Meanwhile, the majority of Chicago Cardiologists have experience with remote monitoring (60%, comparable with national).

Boston providers appear to be highly patient-driven when it comes to remote monitoring consideration/adoption.

  • They are more likely to see patient empower/engagement and patient peace-of-mind as key benefits to remote monitoring (generally more so than other geographies).
  • However, they also perceive greater disinterest/lack of desire among patients as a key barrier.

Overall lack of familiarity may be inhibiting Chicago providers.

  • Overall, providers expect improved outcomes and a more proactive care approach as key benefits, but may struggle to connect this directly through remote monitoring features or processes as a result of limited familiarity.
  • Both patient and clinician familiarity are key barriers in this market, even above or on par with coverage/costs.
  • Among Chicago Cardiologists (who tend to have more direct experience), a lack of patient familiarity and too limited of features are key barriers.

San Francisco providers may be easiest to convince/adopt.

  • Reducing risk of hospitalization is a key benefit for both Cardiologists and non-Cardiologists, followed by proactive care and improving overall outcomes.
  • Barriers tend to be slightly more limited/less than other target markets—with the focus primarily on patient familiarity and coverage concerns. Cardiologists in this market may perceive lack of patient familiarity as general disinterest.

MAT-2011537 v1.0



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