Collaborative Research from MedStar Investigators Evaluate On-Demand Telehealth COVID Screening

A collaborative team of researchers from across MedStar Health recently published research evaluating the performance of on-demand telehealth as an approach to respond to COVID-19. The team included investigators from MedStar Health National Center for Human Factors in Healthcare, MedStar Telehealth Innovation Center and the MedStar Institute for Innovation.

“A Descriptive Analysis of an On-Demand Telehealth Approach for Remote COVID-19 Patient Screening” was published in Journal of Telemedicine and Telecare. The analysis presented by the investigators covers telehealth patient characteristics, measures of patient wait time and visit duration, technical success of the telehealth request and the post-visit trajectory of these patients.

The study evaluated 9,270 on-demand telehealth requests from 7,112 unique patients from March to April 2020.  Each telehealth request was categorized as either a completed encounter in which the patient successfully saw the provider and was given clinical guidance, or an incomplete request in which the patient did not complete an encounter with the provider. For completed encounters, additional analyses were performed, and the patient was provided a survey and asked what they would have done if on-demand telehealth was unavailable.

The results show that out of the over 7,000 unique patients with on-demand telehealth requests, the average patient age was around 38 years old, 4,511 were female and 2,601 were male. Most requests (61.6%) had a visit reason categorized as likely COVID-19 related. The majority (79%) of likely COVID-19 related requests were completed encounters and of these, 19% were referred for in-person care or testing. The average completed encounter wait time was 26 minutes. In addition, there were 1194 requests that were categorized as left without being seen. The average wait time for patients that left without being seen was 19 minutes.

The post-encounter survey, for patients who had a completed visit, indicated that 26% of patients would have gone to an urgent care or retail clinic if on-demand telehealth was unavailable. There were 482 patients (10.7%) who said they would go to their doctor’s office and 267 (5.9%) would go to the ER. The survey showed 9.1% of patients would not have done anything.  There was no response from 48% of completed encounters.

The research concluded that on-demand telehealth service can serve an important public health need in response to the COVID-19 pandemic. According to the survey, 1935 (42.8% of the 4518 COVID-19 related requests) patients would have sought in-person care had they not had access to on-demand telehealth.  There were several patients who stated they would have done nothing about their concerns. On-demand telehealth helps to decrease personal exposure and demonstrates a low-barrier approach to screening patients for COVID-19.

The research team included MedStar Health’s Raj Ratwani, PhD; David Brennan; Bill Sheahan; Allan Fong; Katharine Adams; Allyson Gordon; Mary Calabrese; Elizabeth Hwang; Mark Smith, MD; and Ethan Booker, MD.

Journal of Telemedicine and Telecare, 2020. DOI: 10.1177/1357633X20943339