P173 IMPROVING ACCESS TO HEALTHCARE THROUGH TELEMEDICINE IN AN UNDERSERVED ASTHMA POPULATION DURING THE COVID-19 PANDEMIC

Abstract

Our pediatric pulmonology clinic caters to an underserved community (mostly African-American and Hispanic patients) with barriers to healthcare - such as transportation, poor literacy and language - which contribute to a baseline median “no-show” rate of 33% (January 2019 to March 2020). During the COVID-19 pandemic, families fearful of contracting the virus, missed or canceled in-person visits. Despite improved access via telemedicine patients continued to miss scheduled appointments. We aimed to reduce the no-show rate to 20% over 6 months through expansion of telemedicine. A team of physicians, front-desk staff and nurses educated families on telemedicine. We identified and addressed barriers to activating patient portal accounts, logging in during visits, and offered telemedicine appointments in lieu of in-person visits. We tracked monthly data. PDSA 1: We educated and enrolled patients on a patient portal with an inbuilt telemedicine module. By December 2020, patient portal activation increased from 20% to 85% and telemedicine appointments increased from a baseline of 0% to 75%. PDSA 2: We provided real-time troubleshooting for patients who experienced technical and language issues, and could not log in for telemedicine visits. PDSA 3: Due to excessive time spent during visits troubleshooting with patients, front-desk staff contacted patients prior to visits to address technical issues. We observed a sustained reduction in the no-show rate of 20% and lower. PDSA 4: Patients who missed in-person visits, were offered a telemedicine visit enabling more consistent patient access to healthcare. We reduced the overall no-show rate from a baseline of 33% to 18%.