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Abstract: PO0858

Telemedicine for Nephrology Outpatient Care in a Large Integrated Health System During the COVID-19 Pandemic

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Zafar, Waleed, Geisinger Health, Danville, Pennsylvania, United States
  • Mohan, Prince, Geisinger Health, Danville, Pennsylvania, United States
  • Norfolk, Evan, Geisinger Health, Danville, Pennsylvania, United States
  • Green, Jamie Alton, Geisinger Health, Danville, Pennsylvania, United States
  • Chang, Alex R., Geisinger Health, Danville, Pennsylvania, United States
Background

The COVID-19 pandemic has necessitated increased use of telemedicine for outpatient care. Understanding factors impacting access to telemedicine is important to optimize care delivery during the pandemic.

Methods

We examined trends in telemedicine use during the COVID-19 pandemic using data from Geisinger, a large, integrated, predominantly rural health system in central and northeast Pennsylvania. We also examined the association between patient characteristics (age, sex, patient portal status, Charlson Comorbidity Index [CCI]) and use of televideo nephrology visits.

Results

From 3/15/20-5/29/20, nephrology was the top adult specialty using telemedicine at Geisinger in terms of proportion of office visits using telemedicine (televideo or telephone) with 1911 (94% of all outpatient visits). The proportion of nephrology visits using telemedicine increased rapidly from <1% pre-COVID-19 crisis to 21% (week of 3/15/20) to consistently ≥95% each week from (3/22/20-5/29/20). Visit completion rate during this time was 84% with 8% same-day cancellations and 8% no-shows/left prior to being seen. The majority of nephrology clinic patients were ≥65 years old (63%), had severe CCI score 5+ (70%), and had active patient portal status (65%). The proportion of telemedicine visits using televideo was 42% overall with large differences by age, CCI score, and patient portal status (Figure). For example, the proportion of telemedicine visits using televideo was as low as 10% (65+ year old patients, CCI 5+, non-user of patient portal) and as high as 86% (<50 year old patients, CCI score 0-4, active patient portal users).

Conclusion

Telemedicine may serve an important role in providing nephrology care to elderly patients with many comorbidities who are particularly susceptible to ill effects from COVID-19. Patient portal users were much more likely to use televideo for telemedicine visits. Further investigation into the digital divide (e.g. broadband internet access) is needed to optimize care delivery during the COVID-19 crisis.