Brown Andrew M, Ardila-Gatas Jessica, Yuan Victoria, Devas Nina, Docimo Salvatore, Spaniolas Konstaninos, Pryor Aurora D
Department of Surgery, Stony Brook University Hospital, Stony Brook, NY.
Ann Surg. 2020 Dec;272(6):e306-e310. doi: 10.1097/SLA.0000000000004391.
This study aims to show how full-time telemedicine adoption has impacted patient visit volume and attendance in a comprehensive metabolic and weight loss center.
Elective surgical practices have been profoundly impacted by the global COVID-19 pandemic, leading to a rapid increase in the utilization of telemedicine. The abrupt initiation of audio-video telehealth visits for all providers of a multidisciplinary clinic on March 19 2020 provided unique circumstances to assess the impact of telemedicine.
Data from the clinical booking system (new patient and follow-up visits) for all clinical provider types of the multidisciplinary metabolic center from the pre-telehealth, post-telehealth, and a 2019 comparative period were retrospectively reviewed and compared. The primary outcome is the change in patient visit volume for all clinical providers from before to after the initiation of telemedicine for both new patient, and follow-up visits.
There were a total of 506 visits (162 new patient visits, and 344 follow-ups) in the pre-telehealth period, versus 413 visits (77 new patient visits, and 336 follow-ups) during the post-telehealth period. After telehealth implementation, new visits for surgeons decreased by 75%. Although follow-up visits decreased by 55.06% for surgeons, there was an increase by 27.36% for advanced practitioners. When surgeons were separated from other practitioners, their follow-up visit rate decrease by 55.06%, compared to a 16.08% increase for the group of all other practitioners (P < 0.0001). Dietitians experienced higher rates of absenteeism with new patient visits (10.00% vs 31.42%, P = 0.0128), whereas bariatricians experienced a decrease in follow-up visit absenteeism (33.33% vs 0%, P = 0.0093).
Although new patient visit volume fell across the board, follow-up visits increased for certain nonsurgical providers. This provides a template for adoption of a multidisciplinary telehealth clinic in a post-pandemic world.
本研究旨在展示全面采用远程医疗对一家综合代谢与减肥中心患者就诊量及就诊率的影响。
择期手术业务受到全球新冠疫情的深刻影响,导致远程医疗的使用率迅速上升。2020年3月19日,一家多学科诊所的所有医护人员突然开始采用视频远程医疗问诊,这为评估远程医疗的影响提供了独特的条件。
回顾性审查并比较了多学科代谢中心所有临床医护人员在远程医疗实施前、实施后以及2019年对比期的临床预约系统数据(新患者和随访就诊)。主要结果是远程医疗实施前后所有临床医护人员新患者和随访就诊的患者就诊量变化。
远程医疗实施前共有506次就诊(162次新患者就诊和344次随访),远程医疗实施后为413次就诊(77次新患者就诊和336次随访)。远程医疗实施后,外科医生的新就诊量下降了75%。虽然外科医生的随访就诊量下降了55.06%,但高级执业人员的随访就诊量增加了27.36%。当外科医生与其他执业人员分开统计时,他们的随访就诊率下降了55.06%,而其他所有执业人员组的随访就诊率增加了16.08%(P < 0.0001)。营养师新患者就诊的缺勤率较高(10.00%对31.42%,P = 0.0128),而减肥专科医生随访就诊的缺勤率有所下降(33.33%对0%,P = 0.0093)。
虽然新患者就诊量普遍下降,但某些非手术医护人员的随访就诊量有所增加。这为疫情后世界采用多学科远程医疗诊所提供了一个模板。