Background The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital–based outpatient clinic in one of the worst-hit areas in the world. Objective Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. Methods We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. Results During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. Conclusions There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.
BACKGROUND Coronavirus disease of 2019 (COVID-19), caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has forced health care delivery structure to change rapidly. This disease has further widened the disparities in healthcare and exposed the vulnerable populations even more. It becomes paramount for health care services caring for such populations, to not only continue to operate but come up innovative methods of care delivery during a pandemic without compromising safety. We present our experience of transitioning from a busy university hospital based out-patient clinic to a telehealth clinic, straight from one of worst hit areas in the World. We also present most common challenges faced, benefits over traditional models during COVID-19 pandemic and our opinion on the ‘future’. OBJECTIVE The objective of our study was to look at the adoption of Telemedicine services in the first month of its implication in outpatient practice during COVID-19 pandemic. We also wanted to assess the need for transition to Telemedicine; advantages and challenges faced during the initial phase of adoption of Telemedicine services for our patients. METHODS Prospective data which was compiled for clinic operations including number of appointments, number of sessions and time for each session was collected in the first month of rolling out of Telemedicine to manage clinic operations. The number of successful encounters and encounters where we were unable to establish any contact were also noted. RESULTS Over a period of 4 weeks in the month of April 2020, we had first 110 telemedicine appointments scheduled, out of which, 94 visits (85.4%) were successfully completed and 16 visits were unsuccessful. Out of 19 sessions, 14 sessions were conducted in morning and 5 sessions were conducted in the afternoon. The average duration of audio-video visit was 35 minutes with longest call of 100 minutes. Out of 94 patients, 24 (25.54%) patients were recently discharged from hospital and 70 (74.46 %) patients from the community were seen for urgent care needs. CONCLUSIONS There was high adaptability of telemedicine services by patients, which was evident by high show rates of 85.5% during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, shortage of providers and increased outpatient needs telemedicine was successfully implemented in our practice.
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