Grant: Project Grant

A heartbeat irregularity, known as atrial fibrillation (AF), affects large numbers of older adults and when they develop the condition it progresses more quickly than in younger adults. As a result they often use a lot of health care services such as the emergency department (ED) especially in the first year after they are diagnosed. Rural communities lack specialty (cardiac) care that has been shown to reduce ED use. Specialized AF Clinics located in bigger centers have been shown to reduce older adults' hospital and ED use and improve their ability to manage their condition. The purpose of this study is to adapt an AF clinic located in the city to provide care over distance to rural communities. It will use telehealth to support rural older adults with new AF during the first year of living and managing their condition. It will look at whether the virtual clinic makes a difference in the amount and cost of health care older adults with AF use, their quality of life, health practices, AF knowledge and ability to self-manage the condition. First we will spend time in 5 rural communities to find out from older adults, health providers, and others what their needs are for such a long distance AF clinic service. Second we will gather input from providers and rural older adults who have received care at the onsite clinic about the clinic services and ways to make it user friendly over distance. Third, once the virtual clinic is designed, we will evaluate it with 40 older adults with new AF compared to 40 other older adults with new AF receiving care from their family doctors to see if it makes a difference in outcomes .