S1256 TeleHealth in GI: A United States Survey to Assess Its Impact Amidst COVID-19 Pandemic

Abstract

INTRODUCTION: TeleHealth has garnered a lot of attention amidst the COVID-19 pandemic, and embraced by GI community throughout the United States. While these changes provided healthcare facilities an opportunity to rapidly adopt the remote healthcare delivery model, the uptake and challenges accompanying this practice change are largely unknown. METHODS: A web-based survey was disseminated amongst gastroenterology/hepatology providers (attending physicians, fellows, nurse practitioners, physician assistants), via en masse emails, social media promotion and direct contact by authors, to assess the impact of TeleHealth adoption on clinical practice and GI training programs. RESULTS: 230 respondents (71.7% physicians, 21.3% fellows) completed the survey, with 67.8% academic responses. During COVID era, average weekly half-day clinics increased slightly for GI physicians (P = 0.14), but average number of patients dropped (10.2–6.5; P < 0.001). Respondents from academic centers reported significantly higher use of TeleMedicine (via-phone) (35.8% vs. 25.3%; P = 0.012), in comparison to higher in-person visits in non-academic settings (15.7% vs. 8.7%; P = 0.008). Use of TeleHealth (via-video) was not different between the two settings (P = 0.75). In terms of regional variations, a statistically higher TeleMedicine (via-phone) use was observed in NorthEast (vs. SouthEast, P = 0.005 or West, P = 0.004); top three reasons included less technically inclined population, less platform connectivity burden and fewer privacy concerns. SouthEast had significantly higher in-person visits than NorthEast (P < 0.001). Fellows' participation dropped to less than 50% in attending clinics, and 34.5% fellows noted a compromise in outpatient GI educational mission with adoption of TeleHealth. 95.2% of our respondents foresee future utilization of TeleHealth if adequately reimbursed. CONCLUSION: While our results suggest an almost universal adoption of TeleHealth, we observe a noteworthy variation in its utilization by region and practice type. Furthermore, our survey demonstrates that GI training has suffered significantly with this platform, given lack of consistent supervision in fellows' continuity clinics, and decreased participation in attending clinics. Moreover, our results also emphasize barriers to TeleHealth’s widespread utilization, where lack of adequate equipment/training, patient demographics and reimbursement policies are the foremost challenges.Table 1.: Comparison of outpatient clinics (half-day clinic sessions per week) and patient volume (patients seen per half-day clinic session) before and during COVID-19Figure 1.: Barriers to utilization of TeleHealth and TeleMedicine.