Innovation in Ambulatory Care of Heart Failure in the Era of COVID-19

Leiva, Orly; Bhatt, Ankeet S.; Vaduganathan, Muthiah

Despite steady progress over the last 3 decades in advancing drug and device therapies reduce morbidity and mortality in heart failure with reduced ejection fraction, large registries of usual care demonstrate incomplete use of these evidence-based therapies in clinical practice. A large segment of the heart failure population lives in community settings, at times with limited access to care. Most patient-physician interactions occur in ambulatory clinics, including those that span primary care, cardiology, and advanced heart failure. Innovative ambulatory practice models inclusive of multidisciplinary approaches are critically needed. Potential strategies to improve guideline-directed medical therapy include leveraging non-physician clinicians, solidifying transitions of care, incorporating telehealth solutions, and engaging in comprehensive comorbid disease management via multi-disciplinary team structures. These approaches may be particularly relevant in an era of Coronavirus Disease 2019 and associated need for social distancing, further limiting contact with traditional ambulatory clinic settings.