Study Objectives
In order to prevent spread of an infectious disease such as COVID-19 widespread testing is needed. However, few communities, particularly in states with large rural and medically underserved populations, have the infrastructure or expertise to start such a testing program especially within a short period of time. Further a standardized approach to screening for the appropriateness of COVID-19 testing is critical to not overwhelming hospital and state resources. Telemedicine offers a method which can standardize screening without limitations of catchment area, county and state borders. Our objective was to evaluate the utilization of a telemedicine screening program by patients outside the usual catchment area of a health care system.
Methods
This was a prospective observational study measuring the outcomes of a telemedicine based COVID-19 screening program. The telemedicine health system consists of a single tertiary care hospital on the border of 2 states. The telemedicine screening program was free to the citizens of Georgia and South Carolina. Demographic and location data was collected in the telemedicine app utilized for the telemedicine contacts. Usual catchment area of the telemedicine health system is defined from population health data using patient county of residence.
Results
From March 13, 2020 until June 10, 2020, 24,510 telemedicine visits have been completed with 20,165 (82%) from Georgia and 4345 (18%) from South Carolina. 2649 (10.4%) were less than 20 years of age, 3577 (14.6%) were older than 60 years of age and 211 (0.8%) were older than 80 years of age. 15,280 (62%) were male and 9,355 (38%) female. 15,550 (63.4%) of the telemedicine visits were from citizens of the surrounding 4 counties (catchment area) with the remainder (8,960) spread across Georgia and South Carolina. 15,441 (63%) were sent for COVID-19 testing. Correlation of telemedicine visit from rural counties will be added.
Conclusion
The rapid development and deployment of a statewide COVID-19 screening program is feasible. Citizens will utilize a telemedicine platform outside their home geographic area for screening services unavailable locally. Geographic borders and traditional hospital catchment areas are less significant when utilizing telemedicine allowing for health care to be delivered to rural and health care-poor communities.
