Telemedicine as a component of forward triage in a pandemic

Healthc (Amst). 2021 Sep;9(3):100567. doi: 10.1016/j.hjdsi.2021.100567. Epub 2021 Jul 16.

Abstract

Objective(s): Coronavirus disease 2019 (COVID-19) presents an enormous challenge to healthcare systems globally. Optimizing access to healthcare while minimizing face-to-face patient encounters is critical to limiting exposures, conserving resources, and preserving health. We aimed to evaluate the utility of a COVID-focused telehealth program in avoiding potential in-person visits while maintaining high patient satisfaction.

Methods: All patients with COVID-related virtual visits at our center between March and May 2020 were included. Demographic, satisfaction, and clinical information were gathered using a modified, validated telehealth satisfaction questionnaire disseminated via email or telephone. Data were analyzed using Stata.

Results: Of 581 eligible patients, 180 (31%) responded to the survey. Symptoms (73%) and possible exposure (22%) were the main reasons cited for pursuing a virtual visit; cough (44%) and fever (36%) were the most common presenting symptoms. Regarding patient satisfaction, most patients rated the experience as "very good" or "excellent", and 94% of respondents said they would recommend COVID-focused triage through telehealth to others. Over 81% of patients indicated that, if telehealth was not an option, they would have sought an in-person encounter. Ultimately, only 27% of patients reported pursuing a face-to-face encounter after participating in the virtual visit.

Conclusion: Based on patient self-reporting, telemedicine potentially prevented face-to-face COVID-related encounters. Patients expressed satisfaction with the virtual process and were less likely to pursue in-person consultation. Leveraging a telehealth strategy for forward triage has the potential to reduce exposures while conserving healthcare resources.

Keywords: COVID-19; Coronavirus; Forward triage; Pandemic; Telehealth; Telemedicine.

MeSH terms

  • Adolescent
  • Adult
  • COVID-19*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Patient Satisfaction
  • SARS-CoV-2
  • Telemedicine*
  • Triage*
  • Young Adult