Alzubaidi Ahmad N, Fan Xuanjia, Eidelman Eric, Walter Vonn, Littlejohn Joe O, Raman Jay D
Department of Urology, Penn State Health Milton S. Hershey Medical Center Hershey, PA, USA.
Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center Hershey, PA, USA.
Am J Clin Exp Urol. 2022 Dec 25;10(6):390-396. eCollection 2022.
Telemedicine (TM) was underutilized prior to the COVID-19 pandemic presumably due to non-standardized reimbursement routes and a perceived lack of need. Early experience with the pandemic necessitated this form of medical care, although durability of consistent delivery remains in question. We quantify the utilization patterns of TM over the past 2 years over multiple waves of the pandemic across various service lines in a large rural health system.
Data of TM utilization were prospectively collected between March 2020-January 2022. Rates of adoption among the various surgical and non-surgical services disciplines were compared. Subgroup analyses between different surgical subspecialties and within the urologic subspecialties was performed.
3.5 million visits were recorded; 3.14 million (90%) on-site and 349,989 (10%) TM; 254,919 (73%) video-assisted and 95,070 (27%) were telephonic. Throughout the pandemic, non-surgical services utilized TM to a greater extent than surgical services (mean% 12 vs 6). Significant variation in the utilization among surgical services was reported, with Urology representing a high utilizer (15%); Among Urologic subspecialties utilization, Endourology (28%) was highest and Pediatric Urology (5%) was lowest. Following an initial spike in TM utilization during the pandemic, rates have declined and plateaued at 5-7% of all visits over the past 6-months.
TM utilization in this large health system has remained under 10% following the initial surge in 2020. Non-surgical services preferentially use TM more than surgical domains. Certain subspecialties utilize TM more than others, possible due to patient population, practice patterns and medical conditions. Barriers to adoption are essential to determine the relatively low volume of use across this health system.
在2019冠状病毒病大流行之前，远程医疗（TM）的使用率较低，这可能是由于报销途径不规范以及人们认为没有必要。大流行初期的经验使这种医疗形式成为必要，尽管持续提供的持久性仍存在疑问。我们对一个大型农村卫生系统在过去两年多波大流行期间各服务部门的远程医疗使用模式进行了量化。
前瞻性收集了2020年3月至2022年1月期间的远程医疗使用数据。比较了各种外科和非外科服务学科的采用率。对外科不同亚专业之间以及泌尿外科亚专业内部进行了亚组分析。
记录了350万次就诊；314万次（90%）为现场就诊，349989次（10%）为远程医疗就诊；254919次（73%）为视频辅助就诊，95070次（27%）为电话就诊。在整个大流行期间，非外科服务比外科服务更多地使用远程医疗（平均比例为12%对6%）。报告显示外科服务的使用存在显著差异，泌尿外科是高使用者（15%）；在泌尿外科亚专业的使用中，腔内泌尿外科（28%）最高，小儿泌尿外科（5%）最低。在大流行期间远程医疗使用量最初激增之后，使用率有所下降，并在过去6个月稳定在所有就诊次数的5%-7%。
在2020年最初激增之后，这个大型卫生系统的远程医疗使用率一直低于10%。非外科服务比外科领域更优先使用远程医疗。某些亚专业比其他亚专业更多地使用远程医疗，这可能是由于患者群体、执业模式和医疗状况。确定该卫生系统使用量相对较低的原因，采用障碍至关重要。
