S1236 Telephone Visits Provide Underserved Communities Access to Outpatient Gastroenterology and Hepatology Specialty Services During the COVID-19 Pandemic

Abstract

INTRODUCTION: There is significant research evaluating the use of video-based interfaces to provide care. In underserved communities with limited resources, language barriers and inadequate technology, reduced literacy, and healthcare personnel hinder effective video-based telemedicine. We evaluated patient and provider satisfaction associated with telephone visits providing specialty care services to underserved communities in the setting of social distancing mandates during the COVID-19 pandemic. METHODS: Our study occurred in a gastroenterology (GI) and hepatology clinic in a safety-net healthcare system in Houston, Texas. Patients scheduled from March 30 to May 5, 2020 were triaged to be rescheduled or evaluated by telephone. Patient demographics and need for language interpreters were obtained from the chart. Telephone surveys evaluated patient satisfaction of care, audio quality, time savings, and money savings. Providers were also surveyed to rate satisfaction and feasibility of using telephone encounters to assess diseases. Satisfaction scores were measured using a 5-point Likert scale (5 = very satisfied). Summary statistics were performed. RESULTS: In 36 days, 27 providers completed 248 telephone visits. Of the 188 respondents, the average age was 54, 64% were female, and 39% did not finish high school. Language interpretation was required in 42% of visits. Satisfaction with medical care and audio quality were 4.9 ± 0.4 and 4.8 ± 0.5, respectively. 93.5% of respondents would participate in a telephone encounter again. Average estimated time and money saved were 101 ± 70.2 minutes and $32.7 ± 42.6 compared to in-person appointments. Of the 17 providers who responded, 80% endorsed telephone visits as an acceptable means to provide care. Important physical exam findings were unable to be elicited in 2.6% of visits. Figure 1 shows the feasibility for providers to evaluate diseases or symptoms. Decompensated cirrhosis (2.6 ± 0.9) and IBD (2.9 ± 0.9) were least feasible to evaluate by telephone. CONCLUSION: Telephone visits are associated with high patient and provider satisfaction and significant time and money savings for patients. Certain GI and hepatology diseases are more easily evaluated using telephone visits. Our findings highlight how telephone visits can improve access to care for underserved communities. We hope our experience can guide health systems to maintain patient access to specialty care services beyond the COVID-19 pandemic.Figure 1