Tele-medicine versus face-to-face consultation in Endocrine Outpatients Clinic during COVID-19 outbreak: a single-center experience during the lockdown period

J Endocrinol Invest. 2021 Aug;44(8):1689-1698. doi: 10.1007/s40618-020-01476-2. Epub 2020 Dec 23.

Abstract

Context: The COVID-19 outbreak in Italy is the major concern of Public Health in 2020: measures of containment were progressively expanded, limiting Outpatients' visit.

Objective: We have developed and applied an emergency plan, tailored for Outpatients with endocrine diseases.

Design: Cross-sectional study from March to May 2020.

Setting: Referral University-Hospital center.

Patients: 1262 patients in 8 weeks.

Interventions: The emergency plan is based upon the endocrine triage, the stay-safe procedures and the tele-Endo. During endocrine triage every patient was contacted by phone to assess health status and define if the visit will be performed face-to-face (F2F) or by tele-Medicine (tele-Endo). In case of F2F, targeted stay-safe procedures have been adopted. Tele-Endo, performed by phone and email, is dedicated to COVID-19-infected patients, to elderly or frail people, or to those with a stable disease.

Main outcome measure: To assess efficacy of the emergency plan to continue the follow-up of Outpatients.

Results: The number of visits cancelled after endocrine triage (9%) is lower than that cancelled independently by the patients (37%, p < 0.001); the latter reduced from 47 to 19% during the weeks of lockdown (p = 0.032). 86% of patients contacted by endocrine-triage received a clinical response (F2F and tele-Endo visits). F2F visit was offered especially to young patients; tele-Endo was applied to 63% of geriatric patients (p < 0.001), visits' outcome was similar between young and aged patients.

Conclusions: The emergency plan respects the WHO recommendations to limit viral spread and is useful to continue follow-up for outpatients with endocrine diseases.

Keywords: COVID-19; Endocrine unit; Hub-spoke organization; Telemedicine.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities / organization & administration
  • Ambulatory Care Facilities / statistics & numerical data
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • COVID-19 / transmission
  • Communicable Disease Control* / methods
  • Communicable Disease Control* / organization & administration
  • Cross-Sectional Studies
  • Disease Outbreaks
  • Endocrinology* / methods
  • Endocrinology* / organization & administration
  • Endocrinology* / statistics & numerical data
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data
  • Pandemics
  • Quarantine / methods
  • Quarantine / organization & administration
  • Quarantine / statistics & numerical data
  • Referral and Consultation* / organization & administration
  • Referral and Consultation* / statistics & numerical data
  • SARS-CoV-2 / physiology
  • Telemedicine* / methods
  • Telemedicine* / organization & administration
  • Telemedicine* / statistics & numerical data
  • Triage / methods
  • Triage / organization & administration
  • Triage / statistics & numerical data