RT Journal Article
SR Electronic
T1 Quality and Safety Analysis of 2,999 Telemedicine Encounters During the COVID-19 Pandemic
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP e73
OP e82
DO 10.1212/CPJ.0000000000001025
VO 11
IS 2
A1 Charuta N. Joshi
A1 Michele L. Yang
A1 Krista Eschbach
A1 Suhong Tong
A1 Mona P. Jacobson
A1 Chelsey Stillman
A1 Annmarie E. Kropp
A1 Stephanie A. Shea
A1 Gerard M. Frunzi
A1 J. Fred Thomas
A1 Christina A. Olson
YR 2021
UL http://cp.neurology.org/content/11/2/e73.abstract
AB Objective To examine whether telemedicine remains safe and of high quality despite rapid expansion of services by comparing telemedicine encounters before and during the COVID-19 pandemic.Methods Pre-post study investigating 2,999 telemedicine encounters: February 1, 2020–May 15, 2020, was performed. A total of 2,919 completed visits before and after strict social distancing implementation were analyzed for patient and provider characteristics, encounter characteristics (e.g., history and physical examination), and quality and safety metrics (phone calls ≤ 7 days postvisit, visit-cause–specific hospital admission or mortality ≤ 30 days after visit). Stratified analysis of 3 groups for outcomes (young age, neuromuscular diagnosis, and new encounters) was performed.Results Patients ranging from 1 month to 33 years of age were seen. Rural patients were less likely to be seen during the pandemic compared with urban patients (8% vs 90%; p < 0.0001); teaching clinic and specialty clinic encounters increased significantly during the pandemic (8% vs 3%; p = 0.005), and documentation of at least 2 systems on examination was noted significantly more frequently during the pandemic (13% vs 7%; p = 0.009). No deaths were reported. There were no differences before/during the pandemic in safety or telemedicine failure metrics within the entire group and high-risk subgroups.Conclusions Despite a markedly and rapidly expanded scope of ambulatory telemedicine care during the COVID-19 pandemic, telemedicine remained a safe and high-quality option for pediatric neurology patients. In addition, populations perceived as high risk for telemedicine (the very young, new patients, and those with neuromuscular diagnoses) can benefit from telemedicine visits, particularly when access to in-person care is limited.