46.3 The Impact of the COVID-19 Pandemic and Telehealth on Clinic No-Shows in a Multidisciplinary Mental Health Agency

Abstract

The objective of this study was to compare compliance with appointments via telehealth as compared to in-person appointments. Data were obtained via our electronic health record (EHR) on scheduled appointments, no-shows (NS), late cancels (less than 24 hours [LC]), early cancels (canceled more than 24 hours before appointment [EC]), and attended sessions. The prepandemic in-person data from April 2019 through March 2020 (PRE-PAN) was compared to pandemic telehealth sessions between April 2020 and March 2021 (PAN). The data for all clinic visits were compared, including between professional disciplines (physicians, psychologists/therapists, and trainees). The PRE-PAN visit total was 16,998 out of 21,807 scheduled sessions. The PAN visit total was 19,167 out of 21,765 scheduled sessions. There were 445 (1.7%) PRE-PAN NS vs 328 (1.3%) PAN NS (χ2 = 33.9; p < 0.0001). There were 202 (0.8%) PRE-PAN LC vs 60 (0.2%) PAN LC (χ2 = 94.5; p < 0.0001). Early cancels were 4162 (15.6%) PRE-PAN and 2210 (9.1%) PAN (χ2 = 727.0; p < 0.0001). The only category that did not show significant changes from PRE-PAN to PAN was for NS among nonlicensed clinicians (52 out of 2232 visits PRE-PAN vs 42 out of 1764 visits PAN; both 2.3%; χ2 = 0.011; p = 0.92). This study demonstrated the increase in mental health appointment compliance during the pandemic with significant drops in NS and LC. In addition, the EC of appointments significantly decreased. Almost certainly, the increased compliance with attending appointments was secondary to the easy accessibility to care via telehealth and also more time to focus on mental health treatment. In addition, the unique environmental and social stressors of the pandemic may have exacerbated mental health symptoms and also played a role. Future studies on telehealth vs in-person visit compliance postpandemic will help clarify which factors led to these drastic improvements.