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Comparative Effectiveness of Virtual Versus In-person Visits for Abdominal Pain During the COVID-19 Pandemic.
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- Author(s): Sasankan P;Sasankan P; McMichael J; McMichael J; Lyu R; Lyu R; Rouphael C; Rouphael C; Baggott B; Baggott B; Vargo J; Vargo J; Garber A; Garber A
- Source:
Digestive diseases and sciences [Dig Dis Sci] 2024 Mar; Vol. 69 (3), pp. 720-727. Date of Electronic Publication: 2024 Feb 01.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 7902782 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2568 (Electronic) Linking ISSN: 01632116 NLM ISO Abbreviation: Dig Dis Sci Subsets: MEDLINE
- Publication Information: Publication: 2005- : New York, NY : Springer Science + Business Media
Original Publication: New York, Plenum Pub. Corp. - Subject Terms:
- Abstract: Background and Aims: The COVID-19 pandemic has highlighted the importance of telemedicine in improving healthcare access and reducing costs. This study aimed to assess order compliance in the virtual versus in-person setting for the initial evaluation of abdominal pain (AP) prior to and during the pandemic.
Methods: A retrospective evaluation of virtual and in-person outpatient gastroenterology visits for AP were identified through natural language processing from January 2019 through September 2021 at the Cleveland Clinic main campus and regional hospitals in Ohio. We assessed the number and type of orders placed for patients and measured compliance through order completion. This study received Institutional Review Board approval (IRB 21-514).
Results: Among 20,356 patients at their initial visit, 79% had orders placed, of which 40% had pandemic in-person visits, 13% had pandemic virtual visits, and 47% had pre-pandemic in-person visits. Patients seen virtually were 65.1% less likely to complete orders compared to patients seen in-person (p < 0.001) during the pandemic. Patients seen in a pandemic virtual setting were 71.0% less likely to complete imaging orders (p < 0.001), 82.6% less likely to complete procedure orders (p < 0.001), and 60.5% less likely to complete lab orders (p < 0.001).
Conclusion: Compared with in-person visits, patients seen virtually for their first presentation of AP were less likely to complete labs, imaging, and endoscopic evaluations. In-person visits were more successful with patient order completion during the pandemic. These findings highlight that virtual visits for AP, despite convenience, may compromise care delivery and warrant additional care coordination to achieve compliance with medical recommendations.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) - References: Dobrusin A, Hawa F, Gladshteyn M, Corsello P, Harlen K, Walsh CX, Alaparthi L, Weinstein M, Baig N, Sousa A, Gunaratnam NT. Gastroenterologists and patients report high satisfaction rates with telehealth services during the novel coronavirus 2019 pandemic. Clin Gastroenterol Hepatol 2020;18:2393-2397.e2. https://doi.org/10.1016/j.cgh.2020.07.014 . (Epub 11 July 2020). (PMID: 10.1016/j.cgh.2020.07.014326635217352104)
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Keihanian T, Sharma P, Goyal J, Sussman DA, Girotra M. Telehealth utilization in gastroenterology clinics amid the COVID-19 pandemic: impact on clinical practice and gastroenterology training. Gastroenterology 2020;159:1598–1601. https://doi.org/10.1053/j.gastro.2020.06.040 . (PMID: 10.1053/j.gastro.2020.06.04032569773)
Cross RK, Langenberg P, Regueiro M, Schwartz DA, Tracy JK, Collins JF, Katz J, Ghazi L, Patil SA, Quezada SM, Beaulieu D, Horst SN, Russman K, Riaz M, Jambaulikar G, Sivasailam B, Quinn CC. A randomized controlled trial of TELEmedicine for patients with inflammatory bowel disease (TELE-IBD). Am J Gastroenterol 2019;114:472–482. https://doi.org/10.1038/s41395-018-0272-8 . (PMID: 10.1038/s41395-018-0272-830410041)
Yin AL, Hachuel D, Pollak JP, Scherl EJ, Estrin D. Digital health apps in the clinical care of inflammatory bowel disease: scoping review. J Med Internet Res 2019;21:e14630. https://doi.org/10.2196/14630 . (Published 19 Aug 2019). (PMID: 10.2196/14630314294106718080)
Palmer S, Torgerson DJ. Economic notes: definitions of efficiency. BMJ 1999;318:1136. https://doi.org/10.1136/bmj.318.7191.1136 . (PMID: 10.1136/bmj.318.7191.1136102137351115526)
Cleveland Manchanda EC, Sanky C, Appel JM. Crisis standards of care in the USA: a systematic review and implications for equity amidst COVID-19. J Racial Ethn Health Disparities 2021;8:824–836. https://doi.org/10.1007/s40615-020-00840-5 . (PMID: 10.1007/s40615-020-00840-532789816)
Wegermann K, Patel Y, Wilder J. Health equity and telemedicine in gastroenterology and hepatology. Clin Gastroenterol Hepatol 2021;19:1516–1519. https://doi.org/10.1016/j.cgh.2021.04.024 . (PMID: 10.1016/j.cgh.2021.04.024339570898088969) - Contributed Indexing: Keywords: Abdominal pain; COVID-19; Healthcare quality; Telemedicine
- Publication Date: Date Created: 20240201 Date Completed: 20240325 Latest Revision: 20240325
- Publication Date: 20240325
- Accession Number: 10.1007/s10620-023-08236-1
- Accession Number: 38300419
- Source:
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