The Methodology of the Virtual Clinic in Cardiac Surgery in the Era of COVID-19: Adapting to the Future.

The COVID-19 pandemic forever altered health care delivery models by necessitating expanded use of telehealth technology. While the implementation of telemedicine has been widely discussed among other specialties, cardiac surgery lacks robust literature regarding the use of telehealth in pre- and postoperative care. At our institution, we have implemented a comprehensive telehealth clinic in response to limitations on in-person visits at the start of the COVID-19 pandemic. We seek to share this methodology in the hopes that it can assist other institutions in providing care to those with barriers to in-person visits. In response to restrictions on in-person contact for those seeking medical care during the COVID-19 pandemic, telemedicine/telehealth was introduced and accelerated to allow remote access to health care. Early reports from the pandemic studying the feasi-bility and adaptability of telemedicine revealed that patients were quick to adapt and satisfied with their experience. 1–3 Mann et al showed that after the intro-duction of telehealth across the New York University Langone Health system, telehealth visits increased at a rate of 683% within 6 weeks. Physicians also noted that the transition to telehealth was important in how they delivered care and overcame potential barriers. 4 Within the realm of surgery, telemedicine has played a pivotal role in amplifying patient care. 5 A virtual clinic can optimize efficiency given increased variation in patients’ preference for visit modality (i.e., virtual, in-person, hybrid). This said, some surgical subspecialties have been slow to adopt telehealth, with surgeons citing the inability to perform a comprehensive examination within the visit as a primary barrier to quality care. 5,6 In cardiac surgery, scarce literature has been published on the processes required for an effective telemedicine visit in clinic