Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York; Department of Emergency Medicine, Bellevue Hospital Center, New York, New York.
Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York; Department of Emergency Medicine, Bellevue Hospital Center, New York, New York; Department of Population Health, New York University Grossman School of Medicine, New York, New York.
J Emerg Med. 2020 Oct;59(4):610-618. doi: 10.1016/j.jemermed.2020.06.041. Epub 2020 Jun 12.
The coronavirus disease (COVID)-19 pandemic quickly challenged New York City health care systems. Telemedicine has been suggested to manage acute complaints and divert patients from in-person care.
The objective of this study was to describe and assess the impact of a rapidly scaled virtual urgent care platform during the COVID-19 pandemic.
This was a retrospective cohort study of all patients who presented to a virtual urgent care platform over 1 month during the COVID-19 pandemic surge. We described scaling our telemedicine urgent care capacity, described patient clinical characteristics, assessed for emergency department (ED) referrals, and analyzed postvisit surveys.
During the study period, a total of 17,730 patients were seen via virtual urgent care; 454 (2.56%) were referred to an ED. The most frequent diagnoses were COVID-19 related or upper respiratory symptoms. Geospatial analysis indicated a wide catchment area. There were 251 providers onboarded to the platform; at peak, 62 providers supplied 364 h of coverage in 1 day. The average patient satisfaction score was 4.4/5. There were 2668 patients (15.05%) who responded to the postvisit survey; 1236 (49.35%) would have sought care in an ED (11.86%) or in-person urgent care (37.49%).
A virtual urgent care platform was scaled to manage a volume of more than 800 patients a day across a large catchment area during the pandemic surge. About half of the patients would otherwise have presented to an ED or urgent care in person. Virtual urgent care is an option for appropriate patients while minimizing in-person visits during the COVID-19 pandemic.
冠状病毒病(COVID-19)大流行迅速挑战了纽约市的医疗体系。已经有人建议使用远程医疗来处理急性投诉并将患者从门诊护理中转移出来。
本研究的目的是描述和评估 COVID-19 大流行期间快速扩展的虚拟紧急护理平台的影响。
这是一项针对 COVID-19 大流行高峰期期间在虚拟紧急护理平台就诊的所有患者的回顾性队列研究。我们描述了扩大远程医疗紧急护理能力的情况,描述了患者的临床特征,评估了转至急诊部(ED)的情况,并分析了就诊后调查。
在研究期间,共有 17730 名患者通过虚拟紧急护理就诊;其中 454 名(2.56%)被转至 ED。最常见的诊断是与 COVID-19 相关或上呼吸道症状。地理空间分析表明服务范围广泛。共有 251 名提供者加入了该平台;在高峰期,62 名提供者在 1 天内提供了 364 小时的服务。平均患者满意度评分为 4.4/5。有 2668 名患者(15.05%)对就诊后调查做出了回应;其中 1236 名(49.35%)会选择去 ED(11.86%)或现场紧急护理(37.49%)就诊。
在大流行高峰期,一个虚拟紧急护理平台的规模扩大到每天可以管理 800 多名患者,服务范围广泛。否则,大约一半的患者会选择去 ED 或现场紧急护理就诊。在 COVID-19 大流行期间,虚拟紧急护理是一种合适患者的选择,可以最大限度地减少现场就诊。