Telemedicine reduces cancellations, no-shows in rheumatology clinics
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Retrospective data from a large U.S. health care system demonstrated that telehealth improved no-show rates and cancellations for rheumatology outpatient appointments.
Based on its findings, the system’s rheumatology division will aim for 40% of follow-up visits to be conducted via telemedicine.
“The COVID-19 pandemic has been a huge burden globally. The health care sector has been tremendously affected resulting in reduced access to health care. Many outpatient appointments were cancelled, some clinics closed and nonurgent procedures were placed on hold,” Reem Alkilany, MD, a rheumatology fellow at MetroHealth and one of the study’s co-authors, told Healio Rheumatology. “Our institution, The MetroHealth System, offered telemedicine visits by video or telephone within 1 week of the State of Ohio issuing a statewide order limiting gatherings in March 2020 aiming to offer access to health care while avoiding in-person, face-to-face visits.”
After MetroHealth instituted virtual visits, rheumatology providers reported improved clinic show rates. Researchers aimed to examine and compare rates of completed visits, no shows and cancellations between in-person and telemedicine appointments to determine whether telemedicine has a beneficial effect on access to rheumatology ambulatory clinics.
To do so, they collected data for rheumatology outpatient appointments completed between Jan. 3 and May 31 using the Reporting Workbench within their Epic EHR. Data were divided into two types: in-person or telehealth, stratified by week, and placed into three categories: canceled, no-show and completed.
The 20 weeks’ worth of data were divided into two periods: pre-COVID-19 (Jan. 3 toMarch 15) and during COVID-19 (March 16 to May 31). Only in-person visits were conducted in the first 10-week period, while both in-person and telehealth visits were conducted in the second period.
In the 10-week period during COVID-19, one out of 825 telemedicine appointments were cancelled, compared with 527 in-person appointments in the 10 weeks pre-COVID-19. No-shows also decreased during the COVID-19 period: 121 in-person visits and 70 telemedicine visits vs. 220 in-person visits in the pre-COVID-19 period. This resulted in a modest increase in the number of completed visits during the COVID-19 period (754 telemedicine appoints and 284 in-person appointments) vs. the pre-COVID-19 period (930 completed in-person visits).
“The offering of telemedicine visits had seemingly favorable impacts on access to rheumatology ambulatory clinics at our institution,” Alkilany said. “In addition to our study results, telemedicine can be more convenient to patients regarding transportation and reduced work absenteeism. However, it is important to mention that telemedicine is not always possible, as some patients require procedural interventions. Also, other factors need to be further investigated, including patient and provider satisfaction.”
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Alkilany R. Abstract #1584. Presented at: ACR Convergence 2020; November 5-9, 2020 (virtual meeting).
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