Table 5. Health system outcomes: clinical efficiency.
| Title | Research design | Time of study | Number of visits/patients | Patient cohort | Findings |
|---|---|---|---|---|---|
| Telemedicine versus in-Person Primary Care: Impact on Visit Completion Rate in a Rural Appalachian Population | Retrospective cohort study | 1/19–11/20 | 111,000 visits; 13,000 telehealth | Patients seen in person, video, or phone visit at WVU family medicine outpatient clinics | • 90% visits were with established patients |
| • Rural patients who used telehealth had 20% higher completion rates | |||||
| • Use of telehealth was associated with higher completion rates for older patients with more comorbidities based on LACE index score | |||||
| Telemedicine Associated with Decreased No-Show Visits among Surgical Specialties | Retrospective cohort | 3/20–12/20 | 553,400 patient visits | Telehealth cohort compared to contemporary cohort (3/20–12/20 in-person) and historical cohort (1/18–3/20, in-person) at UAB surgical specialties | • No show rate for in-person appointments was 11.7% |
| • Telehealth visits, including video and audio, had no-show rate of 2.5% | |||||
| • Male gender, black or Asian self-identification, Medicaid insurance, and higher social vulnerability index were associated with higher no show rates | |||||
| • Telehealth was associated with 79% reduction in odds of no-show | |||||
| Clinical Outcomes and Hospital Utilization Among Patients Undergoing Bariatric Surgery With Telemedicine Preoperative Care | Retrospective cohort | 7/20–12/21 | 1,180 patients | Telehealth new patient evaluations compared to historical cohort of in-person new patient surgical evaluation | • Operating room delay was mean 7.8 min (SD 25.1; 95% CI: 5.1 to 10.5) for control cases compared to 4.2 min (SD 11.1; 95% CI: 1.0 to 7.4; P=0.002) for those evaluated with telehealth |
| • Procedure duration was mean 134.4 min (SD 52.8; 95% CI: 130.9 to 137.8) vs. 105.3 min (SD 41.5; 95% CI: 100.2 to 110.4; P<0.001; margin of inferiority set to 45 min) for telehealth evaluations | |||||
| • Length of hospital stay with mean 1.9 days (SD 1.1; 95% CI: 1.8 to 1.9) for in-person eval vs. 2.1 days (SD 1.0; 95% CI: 1.9 to 2.2; P<0.001; margin of inferiority set to 1 day) for telehealth visit | |||||
| The Lack of a Physical Exam During New Patient Telehealth Visits Does Not Impact Plans for Office and Operating Room Procedures | Retrospective review | 3/20–5/20 | 590 patients | Telehealth new, outpatient evaluations | • 195 (33%) were evaluated by new patient video visits and had a procedure or surgery scheduled |
| • 186 (95%) plans were concordant with telehealth evaluation | |||||
| • Days between video visit and in-person evaluation did not differ significantly in concordant cases (median 37.5; IQR, 16–80.5) as compared to discordant cases (median 58.0; IQR, 20–224; P=0.12) |
WVU, West Virginia University; LACE, acronym for L—length patient stay in the hospital, A—acuity of admission of patient in the hospital, C—comorbidity and E—emergency visit; UAB, University of Alabama at Birmingham; SD, standard deviation; CI, confidence interval; IQR, interquartile range.