Telehealth to expand access of oncology care in Utah during COVID-19 pandemic.

Abstract

267 Background: Intermountain Healthcare has used telehealth since 2015 to expand oncology care for patients living in rural Utah communities. Telehealth services have historically not been widely available to patients living in non-rural locations due to restrictions in reimbursement policies. Changes during the COVID-19 pandemic, including the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act, allows for reimbursement of provider professional fees for electronic visits occurring at any location including a patient’s home. This has allowed greater access to telehealth care for patients with cancer, many of whom are at increased risk of contracting SARS-CoV-2. Methods: Patient visits from Intermountain Healthcare’s two largest oncology sites, Intermountain Medical Center and Dixie Regional Medical Center, were evaluated from the electronic health record (iCentra). Four types of encounters were considered “televisits”: scheduled video visits (SVVs), alternative video visits (AVVs), telehealth visits, and phone visits. All visits were synchronous. Patients were seen from home except for telehealth visits where patients were seen remotely from a rural Intermountain site. SVVs occurred over Intermountain’s Connect Care software platform. AVVs utilized a non-Intermountain software such as FaceTime, Google Duo, Skype, or Webex. Visits were analyzed from December 1, 2019 to June 1, 2020. Results: From December 2019 to May 2020, there were 1,798 televisits performed. Three-month televisit totals increased from 175 from December-February to 1,623 from March-May (Table). Intermountain Medical Center increased televisits from 8 to 514 over these same time periods. Conclusions: Televisits have been utilized to maintain continuity of oncology care while minimizing patients’ exposure to healthcare facilities. On May 15, 2020, Governor Gary Herbert issued an executive order de-escalating Utah COVID-19 risk phase from moderate to low-risk. This may be associated with the decrease in televisits from April to May. [Table: see text]