Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Feb 15, 2021
Date Accepted: Jul 10, 2021
Date Submitted to PubMed: Aug 3, 2021
Factors to Effective Telemedicine Visits During the COVID-19 Pandemic
ABSTRACT
Background:
With COVID-19, there was a rapid and abrupt rise in telemedicine implementation often without sufficient time for providers or patients to adapt. Since telemedicine visits are likely to continue to play an important role in healthcare, it is crucial to strive for a better understanding of how to ensure successful telemedicine visits in our health system. Awareness of these barriers to successful telemedicine is necessary for a proactive approach to addressing issues.
Objective:
To identify barriers to successful telemedicine visits and address actionable changes that can be enacted across the entire health system to benefit all patients.
Methods:
Data was collected from scheduled telemedicine visits (N = 362,764) at University of Miami Health System (UHealth) between March 1, 2020 and October 31, 2020. Descriptive statistics, logistic regression, and random forest modeling were used to identify the most important patient-agnostic predictors of telemedicine success.
Results:
Using descriptive statistics, struggling telemedicine specialties, providers, and clinic locations were identified. Through logistic regression, the most important predictors of success included: pre-visit phone/text reminder status, MyUHealthChart patient portal status, provider’s specialty, new to the UHealth system, new to provider, and clinic location. Random forest modeling results mirrored those from logistic regression.
Conclusions:
The highest association with a successful telemedicine visit was the pre-visit appointment confirmation by the patient via phone/text. An active patient portal account was the second strongest variable associated with success, which underscored the importance of patients having set up their portal account before the telemedicine visit. Provider’s specialty was the third strongest patient-agnostic characteristic associated with telemedicine completion rate. Telemedicine will likely continue having an integral role in healthcare, and these results should be used as an important guide to improvement efforts. As a first step towards increasing completion rates, healthcare systems should focus on improvement of patient portal usage and use of pre-visit reminders. Optimization and intervention are necessary for those that are struggling with implementing telemedicine. We advise setting-up a standardized workflow for staff.
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