Assessing the Efficacy of Telemedicine in High-Risk Populations by Evaluating Emergency Department Visits and Hospitalizations

Abstract

Introduction Advances in telemedicine have allowed physicians to provide quality care to high-risk patients with multiple comorbidities who would otherwise be unable to attend an in-person visit. Barriers to the routine use of telemedicine include access to the appropriate devices and understanding how to use applications or software. We hypothesize that patients who were contacted and seen via telemedicine did not have more emergency department visits or hospitalizations compared with patients who had office visits. Methods We conducted an observational quality improvement study with retrospective administrative data collection and analysis. This study took place in an inner-city internal medicine residency primary care clinic. The patient population was defined as those patients 65 years and older with predetermined chronic medical conditions or patients younger than 65 years with chronic health conditions who had not yet had an office, telephone, or video visit within 6 months of March 23, 2020. Results A total of 1340 high-risk individuals were considered for analysis. There were a total of 441 emergency department visits and 254 inpatient hospital admissions within this group. We did not detect a statistically significant difference between emergency department visits or inpatient hospital admissions between telephone, video, or office visits. Conclusions Providing patients with an alternative to an in-office visit may prevent exposures to high-risk patients during the pandemic and provide alternative healthcare access to patients who may struggle with attending their primary care in-office visits.