Enhancing Rural Health Via Cardiovascular Telehealth for Rural Patients Implementation (E-VICTORS)

NCT04617834 | Active Not Recruiting

• 1 other identifier: IRB00068612
• Study Type: observational
• Target: 215
• Locations: 1 country
• Sites: 4

Brief Summary

This pre-post study will evaluate the implementation of a cardiovascular telehealth platform, which will connect experts from the Wake Forest University Health Sciences (WFUHS) tertiary care center with Wilkes County Emergency Medical Services (WC-EMS) system, Wilkes Medical Center Emergency Department (ED), and The Wilkes County Health Department Public Health Community Clinic (PHCC) to improve cardiovascular care in this rural community.

Conditions

Cardiovascular Diseases; Acute Coronary Syndrome

Keywords

acute chest pain; telehealth; implementation science; rural health

Outcome Measures

Primary Outcomes (1)

• Number of Emergency Department (ED) utilization

  ED utilization among patients with cardiovascular symptoms will be defined as the total number of cardiovascular-related ED admissions divided by the total number of unique individual patients receiving cardiovascular care during the project period.

  baseline

Secondary Outcomes (11)

• Number of Cardiovascular hospitalizations

  Baseline

• Number of Cardiovascular Inter-facility transfers

  Baseline

• Number of 30-day cardiovascular Emergency Department (ED) re-admissions

  day 30

• Number of 30-day cardiovascular hospital re-admissions

  day 30

• Number of Adverse Events

  day 30 and Month 12

Other Outcomes (3)

• (ED) Emergency Department length of stay (LOS)

  Baseline

• Time to transfer

  Baseline

• Patient satisfaction Score

  Day 30 and year 1

Study Arms (1)

Quality Surveillance Data

For this quality surveillance study, data will be collected retrospectively through electronic health record (EHR) queries for all eligible patients treated for acute cardiovascular symptoms by one of the study sites.

Other: Quality Surveillance Data Collection

Interventions

Quality Surveillance Data Collection OTHER

Data will be retrospectively collected through EHR queries

Quality Surveillance Data

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The target population is adult patients with cardiovascular symptoms. Therefore, adult patients (\>18 years old) with acute chest pain or dyspnea concerning for acute cardiovascular disease will be eligible.

You may qualify if:

• age \> 18 years at time of index encounter
• Cardiovascular symptoms (chest discomfort or dyspnea consistent with possible ACS) as indicated by the treating provider

You may not qualify if:

• Age \<18
• Traumatic chest pain
• Dyspnea that is clearly from a non-cardiac etiology
• Patients with hemodynamic instability SBP \< 90 mmHg, HR\>160 or \<40 bpm
• Patients requiring intubation/mechanical ventilation

Sponsors & Collaborators

• Wake Forest University Health Sciences: lead
• Health Resources and Services Administration (HRSA): collaborator

Study Sites (4)

Wilkes County Emergency Medical Services

Wilkesboro, North Carolina, 28697, United States

Location

Wilkes County Public Health Community Clinic

Wilkesboro, North Carolina, 28697, United States

Location

Wilkes Medical Center

Wilkesboro, North Carolina, 28697, United States

Location

Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157, United States

Location

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Related Links

• CMS Rural Health Strategy, Accessed 8/27/2018
• Bureau USC. United States Census Bureau QuickFacts. 2020
• Access NC Community Demographics Search. Accessed May 12, 2020.
• HPSA Find
• MUA Find
• Medicare Fee-For-Service Payment
• Health Insurance Coverage in the United States: 2018: United States Census Bureau
• Bureau USC. American Community Survey (ACS).
• Bureau USC. Type of Health Insurance Coverage by State: 2013, 2017, and 2018.
• Local Area Unemployment Statistics Information and Analysis

MeSH Terms

Conditions

Cardiovascular Diseases; Acute Coronary Syndrome

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Vascular Diseases

Study Officials

• Simon A Mahler, MD, MS

  Wake Forest University Health Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 30, 2020
• First Posted: November 5, 2020
• Study Start: February 1, 2021
• Primary Completion: August 31, 2025
• Study Completion (Estimated): August 1, 2026
• Last Updated: January 27, 2026

Record last verified: 2025-08

Locations

US (4)