Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States.
Department of Medicine, Weill Cornell Medicine, New York, NY, United States.
Front Public Health. 2020 Sep 17;8:514. doi: 10.3389/fpubh.2020.00514. eCollection 2020.
During the height of the coronavirus (COVID-19) pandemic, there was an unprecedented demand for "virtual visits," or ambulatory visits conducted video interface, in order to decrease the risk of transmission. To describe the implementation and evaluation of a video visit program at a large, academic primary care practice in New York, NY, the epicenter of the COVID-19 pandemic. We included consecutive adults (age > 18) scheduled for video visits from March 16, 2020 to April 17, 2020 for COVID-19 and non-COVID-19 related complaints. New processes were established to prepare the practice and patients for video visits. Video visits were conducted by attendings, residents, and nurse practitioners. Guided by the RE-AIM Framework, we evaluated the Reach, Effectiveness, Adoption, and Implementation of video visits. In the 4 weeks prior to the study period, 12 video visits were completed. During the 5-weeks study period, we completed a total of 1,030 video visits for 817 unique patients. Of the video visits completed, 42% were for COVID-19 related symptoms, and the remainder were for other acute or chronic conditions. Video visits were completed more often among younger adults, women, and those with commercial insurance, compared to those who completed in-person visits pre-COVID (all < 0.0001). Patients who completed video visits reported high satisfaction (mean 4.6 on a 5-point scale [: 0.97]); 13.3% reported technical challenges during video visits. Video visits are feasible for the delivery of primary care for patients during the COVID-19 pandemic.
在冠状病毒（COVID-19）大流行期间，为了降低传播风险，对“虚拟就诊”（通过视频接口进行的门诊就诊）的需求前所未有。本研究旨在描述在纽约市一家大型学术初级保健实践中实施和评估视频就诊项目的情况，纽约市是 COVID-19 大流行的中心。我们纳入了 2020 年 3 月 16 日至 4 月 17 日期间因 COVID-19 和非 COVID-19 相关疾病预约视频就诊的连续成年患者（年龄>18 岁）。为准备视频就诊，我们为实践和患者建立了新流程。视频就诊由主治医生、住院医生和执业护士进行。我们根据 RE-AIM 框架评估了视频就诊的覆盖范围、效果、采用情况和实施情况。在研究期间之前的 4 周内，完成了 12 次视频就诊。在 5 周的研究期间内，我们共为 817 名患者完成了 1030 次视频就诊。在完成的视频就诊中，42%是针对 COVID-19 相关症状，其余是针对其他急性或慢性疾病。与 COVID 之前完成现场就诊的患者相比，年轻患者、女性和商业保险患者完成视频就诊的比例更高（所有 P 值均<0.0001）。完成视频就诊的患者报告满意度高（5 分制平均 4.6 分[0.97]）；13.3%的患者报告就诊过程中存在技术挑战。在 COVID-19 大流行期间，视频就诊可为患者提供初级保健服务。
