JMIR Publications

ABSTRACT

Background:

Coronavirus disease of 2019 (COVID-19), caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has forced health care delivery structure to change rapidly. This disease has further widened the disparities in healthcare and exposed the vulnerable populations even more. It becomes paramount for health care services caring for such populations, to not only continue to operate but come up innovative methods of care delivery during a pandemic without compromising safety. We present our experience of transitioning from a busy university hospital based out-patient clinic to a telehealth clinic, straight from one of worst hit areas in the World. We also present most common challenges faced, benefits over traditional models during COVID-19 pandemic and our opinion on the ‘future’.

Objective:

The objective of our study was to look at the adoption of Telemedicine services in the first month of its implication in outpatient practice during COVID-19 pandemic. We also wanted to assess the need for transition to Telemedicine; advantages and challenges faced during the initial phase of adoption of Telemedicine services for our patients.

Methods:

Prospective data which was compiled for clinic operations including number of appointments, number of sessions and time for each session was collected in the first month of rolling out of Telemedicine to manage clinic operations. The number of successful encounters and encounters where we were unable to establish any contact were also noted.

Results:

Over a period of 4 weeks in the month of April 2020, we had first 110 telemedicine appointments scheduled, out of which, 94 visits (85.4%) were successfully completed and 16 visits were unsuccessful. Out of 19 sessions, 14 sessions were conducted in morning and 5 sessions were conducted in the afternoon. The average duration of audio-video visit was 35 minutes with longest call of 100 minutes. Out of 94 patients, 24 (25.54%) patients were recently discharged from hospital and 70 (74.46 %) patients from the community were seen for urgent care needs.

Conclusions:

There was high adaptability of telemedicine services by patients, which was evident by high show rates of 85.5% during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, shortage of providers and increased outpatient needs telemedicine was successfully implemented in our practice.