Background: With the onset of the COVID-19 pandemic, telemedicine was rapidly implemented in care settings globally. To understand what factors affect the successful completion of telemedicine visits in our urban, academic family medicine clinic setting, we analysed telemedicine visits carried out during the pandemic.
Methods: We conducted a retrospective chart review of telemedicine visits from 2 clinical units within a family medicine centre. To investigate the association between incomplete visits and various factors (age, gender, presenting complaints, physician level of training [resident or staff] and patient-physician relational continuity), we performed a multivariable logistic regression on data from August 2020, February 2021, and May 2021. An incomplete visit is one that requires a follow-up in-person visit with a physician within 3 days.
Results: Of the 2,138 telemedicine patient visits we investigated, 9.6% were incomplete. Patients presenting with lumps and bumps (OR: 3.84, 95% CI: 1.44, 10.5), as well as those seen by resident physicians (OR: 1.77, 95% CI: 1.22, 2.56) had increased odds of incomplete visits. Telemedicine visits at the family medicine clinic (Site A) with registered patients had lower odds of incomplete visits (OR: 0.24, 95% CI: 0.15, 0.39) than those at the community clinic (Site B), which provides urgent/episodic care with no associated relational continuity between patients and physicians.
Conclusion: In our urban clinical setting, only a small minority of telemedicine visits required an in-person follow-up visit. This information may be useful in guiding approaches to triaging patients to telemedicine or standard in-person care.
Keywords: continuity of patient care; graduate medical education; primary health care; telehealth; telemedicine; virtual medicine.
With the onset of the COVID-19 pandemic, telemedicine was rapidly implemented in care settings globally. To understand what factors affect the successful completion of telemedicine visits in our urban, academic family medicine clinic, we analysed telemedicine visits carried out during the pandemic. On the basis of patient charts, we investigated the association between incomplete visits (telemedicine visits requiring in-person follow-up within 3 days) and various factors (age, gender, presenting complaints, whether the treating physician was a resident or staff doctor, and whether the patient and physician had a prior clinical relationship). Patients presenting with lumps and bumps and those seen by resident physicians had higher odds of being asked to come in-person for further evaluation. Overall, though, these required in-person follow-ups were uncommon: less than 10% of telemedicine visits resulted in the patient physically coming to the clinic within 3 days. The findings of our study could help guide patients to appropriate care services.
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