Outpatient Telemedicine Evaluation Of The Vascular Patient During The Covid-19 Pandemic
Adham N. Abou Ali, MD, Patrick Cherfan, MD, Othman Abdul-Malak, MD, Mohammad Eslami, MD, Efthymios Avgerinos, MD, Natalie D. Sridharan, MD.
University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
OBJECTIVES: The coronavirus pandemic has led to a rapid expansion in telemedicine across all medical fields. The objective of our study was to describe our initial experience with telemedicine and its application in the care of vascular surgery patients. METHODS: Consecutive patients undergoing telemedicine evaluation between February24, 2020 (the launch of our telemedicine program) and July01, 2020 were reviewed. Baseline demographic and follow-up outcomes were obtained. Google maps was used to calculate the shortest travel distance from patientís home to clinic. Reason for visit was categorized as one of the following: peripheral arterial, venous, aortic aneurysm, carotid, dialysis access, or miscellaneous disease. Follow-up plan from each telemedicine visit (in-person visit, hospital admission, additional telehealth visits, or surgery) was documented.
RESULTS: 630 telemedicine visits (9.7% of total visits; 505 patients) occurred during the study period. Baseline demographics are presented in Table 1. There were no significant demographic differences in patients undergoing telemedicine visits vs. in-person encounters. The majority of telemedicine visits were return visits (98.4%) distributed accordingly: peripheral arterial disease (36.8%), followed by venous (16.5%), aortic aneurysm (12.5%), carotid (9.0%), dialysis access (8.7%), and miscellaneous (8.3%). 31.6% of telehealth encounters involved wound assessment and management. Outcomes of telehealth visits were as follows: 60.4% (44.9% with testing, 15.5% without testing) of patients had in-person follow-up visits (mean duration to follow-up: 39.6days), 16.3% were offered further telemedicine evaluation (mean duration to follow-up: 18.6days), 5.8% had plans for hospital admission, and 6.4% were scheduled for elective surgery. There were 2(0.4%) deaths, 8(1.6%) unplanned vascular surgeries and 15(3.0%) unplanned vascular-related admissions (9 peripheral arterial, 4 dialysis, 1 aortic aneurysm, 1 venous) within 30 days of the last telemedicine evaluation. The mean travel distance saved was 22.0 miles(Range:0.3-204.0). Post-telehealth visit surveys (n=19) revealed that 84.2% of patients were satisfied with the providerís explanation of their condition and 68.4% of patients would recommend a telemedicine visit. CONCLUSIONS: The COVID-19 pandemic and the need for social distancing led to rapid expansion of telemedicine in our institution. Outpatient telemedicine evaluation for a variety of vascular pathologies appears to be feasible, convenient, and acceptable to patient and provider.
|N=505 patients (630 visits)|
|Race (African American)||10.0%|
|Coronary Artery Disease||33.3%|
|Peripheral Arterial Disease||36.2%|
|Physician Performing Evaluation||50.8%|
|Video Technology Available||56.4%|
Back to 2021 ePosters