Interdisciplinary Approach To Comprehensive Virtual Patient Care In Lung Transplant

Purpose Lung transplant (LT) programs typically serve patients from a broad geographic area. A regionalized approach to LT care offers advantages, but patients must relocate or travel to access care. We initiated a small pilot project of a virtual care platform, MyCareConnection (MCC) in LT. We hypothesized that patients and providers would be able to use MCC for communication and monitoring with high satisfaction rates. Methods The pilot began in 01/20, however, in response to the COVID-19 pandemic, we rapidly enrolled many listed and early post-op patients. Exclusion criteria included; limited access to technology (a recent model phone, wifi) or if they were unwilling/ unable to participate. MCC provides access to an online library of educational materials, secure asynchronous texting, a secure video platform, the ability to collect outcome data via surveys and biometrics (BP, HR, temp, SpO2, spirometry, step counts). MCC was used to deliver virtual clinic visits. Tailored home-based physiotherapy was also delivered over MCC (reported separately). Satisfaction was measured by surveys sent to patients, caregivers and staff. Results 165 LT patients are enrolled in MCC (64 pre-LTx, 101 post-LTx), 36% female, mean age 57.7y (range 20-76y). Few patients were ineligible, but the reasons included; personal preference, old OS, no wifi, delisting and death. The primary indications for listing and LT were ILD (45%), COPD (30%) and CF (7%). 70 users (35 clinicians) performed over 998 video calls, and \u003e 3000 sets of biometric data were recorded by patients. Patient and caregiver satisfaction was excellent, with 94% of recipients (n=35) and 100% of caregivers (n=7) reporting that they would recommend MCC to others, and 75% agreeing that it helped them manage their health condition (n=106). Provider satisfaction was high, with over 70% recommending MCC (n=17). Challenges included the rapid shift to virtual care for clinicians used to in-person care. Conclusion We have provided comprehensive, interdisciplinary virtual care to more than 165 LT patients. Good patient and staff satisfaction and high uptake of the MCC platform demonstrates that virtual care is highly desirable and feasible in this population. In person assessments are still required for assessment of some complex issues. Gaps to be addressed include inequitable access to technology because of financial, geographical and other issues.