Shah Kaustav P, Triana Austin J, Gusdorf Roman E, McCoy Allison B, Pabla Baldeep, Scoville Elizabeth, Dalal Robin, Beaulieu Dawn B, Schwartz David A, Griffith Michelle L, Horst Sara N
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Vanderbilt University Medical Center, Department of Bioinformatics, Nashville, Tennessee, USA.
Inflamm Bowel Dis. 2022 Mar 2;28(3):358-363. doi: 10.1093/ibd/izab068.
This study evaluated synchronous audiovisual telehealth and audio-only visits for patients with inflammatory bowel disease (IBD) to determine frequency of successful telehealth visits and determine what factors increase the likelihood of completion.
Data were collected from March to July 2020 in a tertiary care adult IBD clinic that was transitioned to a fully telehealth model. A protocol for telehealth was implemented. A retrospective analysis was performed using electronic medical record (EMR) data. All patients were scheduled for video telehealth. If this failed, providers attempted to conduct the visit as audio only.
Between March and July 2020, 2571 telehealth visits were scheduled for adult patients with IBD. Of these, 2498 (99%) were successfully completed by video or phone. Sixty percent were female, and the median age was 41 years. Eighty six percent of the population was white, 8% black, 2% other, and 4% were missing. Seventy-five percent had commercial insurance, 15% had Medicare, 5% had Medicaid, and 5% had other insurance. No significant factors were found for an attempted but completely failed visit. Using a multivariate logistic regression model, increasing age (odds ratio, 1.80; 95% CI, 1.55-2.08; P < 0.05), noncommercial insurance status (odds ratio, 1.89; 95% CI, 1.61-2.21; P < 0.05), and black race (odds ratio, 2.07; 95% CI, 1.38-3.08; P < 0.05) increased the likelihood of a video encounter failure.
There is a high success rate for telehealth within an IBD population with defined clinic protocols. Certain patient characteristics such as age, race, and health insurance type increase the risk of failure of a video visit.
本研究评估了炎症性肠病（IBD）患者的同步视听远程医疗和仅音频问诊，以确定远程医疗问诊成功的频率，并确定哪些因素会增加完成问诊的可能性。
2020年3月至7月，在一家转为完全远程医疗模式的三级成人IBD诊所收集数据。实施了远程医疗方案。使用电子病历（EMR）数据进行回顾性分析。所有患者均安排视频远程医疗问诊。如果失败，医护人员尝试仅通过音频进行问诊。
2020年3月至7月期间，为成年IBD患者安排了2571次远程医疗问诊。其中，2498次（99%）通过视频或电话成功完成。60%为女性，中位年龄为41岁。86%的患者为白人，8%为黑人，2%为其他种族，4%种族信息缺失。75%有商业保险，15%有医疗保险，5%有医疗补助，5%有其他保险。未发现导致尝试但完全失败的问诊的显著因素。使用多因素逻辑回归模型，年龄增加（比值比，1.80；95%置信区间，1.55 - 2.08；P < 0.05）、非商业保险状态（比值比，1.89；95%置信区间，1.61 - 2.21；P < 0.05）和黑人种族（比值比，2.07；95%置信区间，1.38 - 3.08；P < 0.05）会增加视频问诊失败的可能性。
在有明确诊所方案的IBD患者群体中，远程医疗成功率很高。某些患者特征，如年龄、种族和健康保险类型，会增加视频问诊失败的风险。
