Iowa City VA Health Care System
APP(S), DEVICE(S), OR PLATFORM(S) USED
Patients are contacted weekly by video appointments through the Veterans Affairs (VA) Video connect platform. If Veterans do not have access to internet or a device capable of completing a video appointment one can be provided to them.
The home-based cardiac rehab program utilizes the VA Annie App. Patients can enroll in the Home-Based Cardiac Rehab Annie Health Subscription and receive automated Annie text messages with educational and motivational messages regarding their heart health.
Finally, the program also uses VA My HealtheVet, where patients can send a secure online nonemergent message with information or questions to their cardiac rehabilitation provider.
Cardiac rehabilitation is an essential intervention for patients with cardiovascular disease, however, despite the overwhelming evidence and guidelines it is underutilized. Many Veterans face barriers to attending cardiac rehabilitation services (for example, program availability, distance to travel, employment, costly copayments, etc.).
The Veterans Affairs Office of Rural Health Home-based Cardiac Rehabilitation Program provides Veterans with timely, convenient access to critical specialty care services they may otherwise be unable to obtain. This twelveweek cardiac rehabilitation program is delivered through video and/or telephone appointments and provides individualized care in the areas of exercise prescription, nutritional counseling, medication adherence, stress management, and tobacco cessation.
Over 6,000 veterans have been served by the program since implementation with over 35 active facilities offering the program. The program monitors outcomes related to depression, cardiac selfefficacy, functional exercise, medication adherence, anxiety, and nutrition assessment.
Veterans completing the program have demonstrated significant improvements in exercise and physical activity (Six Minute Walk Distance, selfreported daily steps, Duke Activity Status Index), depression, nutrition habits, weight loss, and cardiac selfefficacy (Drwal, 2021).
In addition to significant improvements in health outcomes, patients report being highly satisfied with their care in the home-based cardiac rehab program scoring a 28.7 out of 30 on the patient satisfaction survey at completion of the program (Drwal, 2021).