The Logistics of Medication and Patient Flow in Video-Based Virtual Clinics During a Sudden COVID-19 Outbreak in Taiwan: Observational Study (Preprint)

Abstract

BACKGROUND The COVID-19 pandemic was well controlled in Taiwan, until an outbreak in May 2021. Telemedicine was rapidly implemented to avoid further patient exposure and to unload the already burdened medical system. OBJECTIVE To understand the effect of COIVD-19 on the implementation of virtual clinic during this outbreak, we analyzed the logistics of medication prescription and patient flow for video-based virtual clinic visits in a tertiary medical center. METHODS We retrospectively collected information on video-based virtual clinic visits and face-to-face outpatient visits from May 1st to August 31st 2021 from the administrative database at the National Taiwan University Hospital. The number of daily new confirmed COVID-19 cases in Taiwan was obtained from an open resource. RESULTS There were 782 virtual clinic visits during these 3 months. These visits were mostly for the internal medicine, neurology and surgery departments. The 3 most common categories of medications prescribed were cardiovascular, diabetic and gastrointestinal. Cardiovascular medications comprised around one third of the total medications prescribed during this period in our virtual clinic. The number of virtual clinic visits was significantly correlated with the number of daily new confirmed COVID-19 cases, with approximately a 20-day delay (correlation coefficient 0.735, P<.001). The patient waiting time for video-based virtual clinic visits was significantly shorter compared with face-to-face clinic visits during the same period (median 3 [IQR 2-6] min vs median 20 [IQR 9-42] min, ranksum P<.001). Although the time saved was appreciated by patients, online payment with direct delivery of medication without the need to visit a hospital was still the major concern among patients. CONCLUSIONS Our data showed that video-based virtual clinics can be implemented rapidly after a COVID-19 outbreak. Video-based virtual clinics were efficient, as demonstrated by the significantly reduced waiting times. However, there are still some barriers to large scale implementation of video-based virtual clinics. Better preparation is required to improve our performance in possible future large outbreaks. CLINICALTRIAL n/a