Barry A. Franklin, Ph.D., chair of the writing committee for the Scientific Statement “Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update from the American Heart Association, (February 2020), director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, and professor of internal medicine at Oakland University William Beaumont School of Medicine in Rochester, Michigan. Offering perspective on AHA Scientific Sessions 2020 Presentations P2365 and P664 copyright American Heart Association 2020 "Overall, both studies, the one from Canada and one from Japan covered very, very general outcomes. The one from Canada basically concluded, they used web-based, they used e-visits, telephone, email and so on and so forth. And they came to the conclusion that overall patient adherence and acceptance was comparable to more supervised programs. Overall, they found that an increased number of referrals and once again, good attendance. I think the major problem they noticed was the cost per patient was virtually doubled because it involved the individual attention. One of the beauties of group rehab programs is that we have five patients or 10 patients to one staff member. So here they were going almost one-on-one. But one with respect to that was done in Japan via Tokyo was primarily on heart failure patients and they found no major difference in readmission rates whether they went through conventional cardiac rehab or virtual cardiac rehab and interestingly enough and it wasn't that surprising to me, they found better overall quality of life scores, short-term once again with the virtual which allowed them to talk directly to the therapist, to the cardiologist and so on and so forth. I think the major criticism I have is that both studies are really short-term studies, they looked at a limited number of outcomes And I for one as a researcher in cardiac rehab for many, many years, spend much more time looking at what changes occurred in exercise capacity, coronary risk factors, lifestyle changes, their diet, their weight and so on and so forth, prescribed medications, depression, scores et cetera. So I think these were contributions to the literature, they show that some of the basic nuts and bolts that are being done on supervised group programs could be done virtually but they still left a lot of questions to be answered."