Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Weill Cornell Medicine/Sloan-Kettering/Rockefeller Tri-Institutional MD-PhD Program, New York, NY, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221114831. doi: 10.1177/21501319221114831.
In this report, we outline our approach to implementing a hybrid in-person and virtual clinic model at a student-run free clinic (SRFC) during the COVID-19 pandemic. Individuals of low socioeconomic status (SES) are at an increased risk for COVID-19 infection and severe clinical outcomes. It is unclear if telehealth is a viable continuity of care enabler for the underserved.
The Weill Cornell Community Clinic (WCCC) implemented a novel telehealth clinic model to serve uninsured patients in May 2020. A phone survey of was conducted to assess WCCC patients access to technology needed for telehealth visits (eg, personal computers, smartphones). Patient no-show rates were retrospectively assessed for both in-person (pre-pandemic) and hybrid continuity of care models.
The phone survey found that 90% of WCCC patients had access to technology needed for telehealth visits. In the 8 months following implementation of the hybrid model, telehealth and in-person no-show rates were 11% (14/128) and 15% (10/67) respectively; the combined hybrid no-show rate was 12% (24/195). For comparison, the in-person 2019 no-show rate was 23% (84/367). This study aligns with previous reports that telehealth improves patient attendance.
Literature on the transition of SRFCs from in-person to telehealth care delivery models is limited. At the WCCC, the reduction in no-show rates supports the feasibility and benefits of adopting telehealth for the delivery of care to underserved patient populations. We believe the hybrid telehealth model described here is a viable model for other student run free clinics to increase access to care in low SES communities.
在本报告中，我们概述了在 COVID-19 大流行期间，我们在学生经营的免费诊所（SRFC）实施混合门诊和虚拟诊所模式的方法。社会经济地位（SES）较低的个体感染 COVID-19 和出现严重临床结果的风险增加。目前尚不清楚远程医疗是否是服务不足人群的可行连续护理实现方式。
威彻斯特康奈尔社区诊所（WCCC）于 2020 年 5 月实施了一种新的远程医疗诊所模式，为未投保的患者提供服务。对 WCCC 患者进行了电话调查，以评估他们是否有接受远程医疗访问所需的技术（例如个人计算机、智能手机）。回顾性评估了在个人（大流行前）和混合连续性护理模型下的患者失约率。
电话调查发现，90%的 WCCC 患者有接受远程医疗访问所需的技术。在实施混合模型后的 8 个月中，远程医疗和门诊失约率分别为 11%（14/128）和 15%（10/67）；混合失约率为 12%（24/195）。相比之下，2019 年门诊失约率为 23%（84/367）。这项研究与之前的报告一致，即远程医疗提高了患者的就诊率。
关于 SRFC 从门诊向远程医疗护理模式过渡的文献有限。在 WCCC，失约率的降低支持采用远程医疗为服务不足的患者群体提供护理的可行性和益处。我们认为，这里描述的混合远程医疗模式是其他学生经营的免费诊所增加低收入社区获得护理的可行模式。
