Congestive Heart Failure Patient Example
Michael Imburgia, MD, Cardiology Specialist at AristaMD
Patient example
The first patient I have is a 68-year-old gentleman who has a history of diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, and had a previous kidney transplant.
They presented with palpitations in the past, had a negative workup. Their blood pressure looks at goal. Their heart rate’s a little fast. It’s 94. Their physical exam’s otherwise unremarkable. ECG is a little bit abnormal, but they had an echocardiogram that showed mild con hypertrophy, normal LV systolic function, grade one diastolic dysfunction, and mild aortic valve calcification, so that patient is stage B. They have evidence of underlying structural heart disease, and so our guideline based therapy should be, since the rejection fraction is normal, aggressive risk factor modification, making sure their heart rate and blood pressure is under control and promoting a healthy lifestyle since he has a history of diabetes.
You can also make an argument to get that patient on an SGLT two inhibitor.
Five Ways eConsults Support Value-Based Care
Combine your referral management platform with an eConsult solution to reduce patient wait times and the cost of care. Learn five ways our eConsults support value-based care by allowing primary care physicians, nurse practitioners or PAs to submit electronic requests for patient advice to our team of specialists to manage low-acuity patients.
#1 Help Patients Avoid Unnecessary Face-to-Face Specialty Visits
About 70% of eConsults can address what physicians typically send for a face-to-face specialty visit. As a web-based physician-to-physician consultation, there is no need for any particular technology or integration — the PCP orders the referral the same way they would traditionally order one. Or suppose the patient was to go face-to-face for a specialty consult with the provider using our referral nurse coordination, RNN service, and nurse navigators. In that case, our nurse will curate the eConsults by grabbing all of the data needed for the patient from the chart. Private health information is then sent to our specialist, who reviews the data and provides an evidence-based response on that patient’s best practice and management. Within four to six hours, the primary care provider receives a notification and can view the eConsult specialist’s recommendations.
The bottom line — for every specialty visit where we serve the patient using an eConsult and address issues through the primary care provider, we can fend off the need for three face-to-face visits. Also, once you gain specific knowledge from a specialist on a particular condition, you have the answer to the same question when it comes up again.
Michael Imburgia, MD
Cardiology Specialist at AristaMD
Dr. Michael Imburgia is a board-certified Cardiologist. He attended medical school at Southern Illinois University School of Medicine. Dr. Imburgia completed his residency and a Cardiology fellowship at Jewish Hospital through Washington University Medical Center in St. Louis. He has practiced cardiology for over 30 years. Dr. Imburgia started Louisville Cardiology in 1997, now Baptist Health Louisville Cardiology. He is the founder and Medical Director of Have the Heart Clinic in Louisville.