Cardiac Rehabilitation during the COVID-19 Era: Guidance on Implementing Virtual Care

Moulson, Nathaniel; Bewick, David; Selway, Tracy; Harris, Jennifer; Suskin, Nelville; Oh, Paul; Coutinho, Thais; Singh, Gurmeet; Chow, Chi-Ming; Clarke, Brian; Cowan, Simone; Fordyce, Christopher B.; Fournier, Anne; Gin, Kenneth; Gupta, Anil; Hardiman, Sean; Jackson, Simon; Lamarche, Yoan; Lau, Benny; Légaré, Jean-François; Leong-Poi, Howard; Mansour, Samer; Marelli, Ariane; Quraishi, Ata ur Rehman; Roifman, Idan; Ruel, Marc; Sapp, John; Small, Gary; Turgeon, Ricky; Wood, David A.; Zieroth, Shelley; Virani, Sean; Krahn, Andrew D.

Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared to centre-based programs. In order to minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation however can be daunting. Centres should initially focus on the collation, utilization and re-purposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed prior to COVID-19, and to improve cardiac rehabilitation delivery moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time.