Improved Outpatient Medical Visit Compliance with Sociodemographic Discrepancies in Vascular Telehealth Evaluations.

OBJECTIVE: The coronavirus pandemic has led to a rapid expansion in telemedicine across all medical fields but has also exposed tele-healthcare disparities with differing access to technology across racial and ethnic groups. The objective of our study was to investigate the impact of telehealth on vascular visit compliance and to explore the effect of sociodemographic factors on vascular surgery outpatient telehealth utilization during the COVID-19 pandemic. METHODS: Consecutive patients undergoing outpatient vascular surgery evaluation between February 24, 2020 (the launch of our telemedicine program) and December 31, 2020, were reviewed. Baseline demographic and outcomes were obtained from the electronic medical record. Telehealth or in-person evaluations were defined according to the patient's index visit during this period. Medical visit compliance was established upon completion of the telehealth or in-person encounter. Chi square tests and logistic regression analyses were used. RESULTS: There were 23,553 scheduled outpatient visits for 10,587 patients during the study period. 1,559 of those were scheduled telehealth encounters compared to 21,994 scheduled in-persons encounters. Out of the total scheduled outpatient encounters, 13,900 medical visits (59.0%) were completed: 1,183 telehealth visits and 12,717 in-person visits. The mean travel distance saved for telehealth visits were 22.1±27.1 miles and the mean travel time saved was 46.3±41.47 minutes. We noted no sociodemographic differences between patients scheduled for telehealth vs. in-person visits. There was a trend towards a lower proportion of African American patients among the telehealth group vs. in-person group (7.8% vs. 10.6%, P=.116) respectively; however, this did not reach statistical significance. There was a significantly higher rate of medical visit completion among the telehealth group compared to the in-person group (79.5% vs. 59.4%, P<.001). Among patients who were scheduled for an outpatient medical visit, having a scheduled telemedicine evaluation (vs. in-person) was associated with 2.3 times the odds of completing the medical visit (Odds Ratio (OR)=2.31, 95% Confidence Interval (CI): 2.05-2.61) adjusting for age, sex, race, ethnicity, language and the distance between the patient's home zip code and the outpatient vascular center zip code. Selecting for scheduled telemedicine visits, African American patients were associated with decreased odds of telemedicine utilization (OR=0.73, 95%CI:0.59-0.90) after adjusting for age, sex, ethnicity, language and visit type. CONCLUSIONS: The vascular surgery outpatient telehealth evaluation appears to improve medical visit completion in our region with apparent sociodemographic disparities. Further studies are needed to confirm if telemedicine expansion has improved access to care in other geographical areas.

Vascular Telehealth Improves Outpatient Visit Compliance Without Sociodemographic Discrepancies

Objective: The COVID-19 (coronavirus disease 2019) pandemic has led to a rapid expansion in telemedicine across all medical fields but has also exposed telehealthcare disparities, with differing access to technology across racial and ethnic groups. The objective of our study was to investigate the sociodemographic aspects of vascular surgery outpatient telehealth evaluations during the COVID-19 pandemic.

Dataset of the vascular e-Learning during the COVID-19 pandemic (EL-COVID) survey.

This dataset supports the findings of the vascular e-Learning during the COVID-19 pandemic survey (the EL-COVID survey). The General Data Protection Regulation (GDPR) of the European Union was taken into consideration in all steps of data handling. The survey was approved by the institutional ethics committee of the Primary Investigator and an online English survey consisting of 18 questions was developed ad-hoc. A bilingual English-Mandarin version of the questionnaire was developed according to the instructions of the Chinese Medical Association in order to be used in mainland People's Republic of China. Differences between the two questionnaires were minor and did affect the process of data collection. Both questionnaires were hosted online. The EL-COVID survey was advertised through major social media. All national and regional contributors contacted their respective colleagues through direct messaging on social media or by email. Eight national societies or groups supported the dissemination of the EL-COVID survey. The data provided demographics information of the EL-COVID participants and an insight on the level of difficulty in accessing or citing previously attended online activities and whether participants were keen on citing these activities in their Curricula Vitae. A categorization of additional comments made by the participants are also based on the data. The survey responses were filtered, anonymized and submitted to descriptive analysis of percentage.

Vascular e-Learning During the COVID-19 Pandemic: The EL-COVID Survey.

BACKGROUND: The corona virus disease (COVID-19) pandemic has radically changed the possibilities for vascular surgeons and trainees to exchange knowledge and experience. The aim of the present survey is to inventorize the e-learning needs of vascular surgeons and trainees as well as the strengths and weaknesses of vascular e-Learning. METHODS: An online survey consisting of 18 questions was created in English, with a separate bilingual English-Mandarin version. The survey was dispersed to vascular surgeons and trainees worldwide through social media and via direct messaging from June 15, 2020 to October 15, 2020. RESULTS: Eight hundred and fifty-six records from 84 different countries could be included. Most participants attended several online activities (>4: n = 461, 54%; 2-4: n = 300, 35%; 1: n = 95, 11%) and evaluated online activities as positive or very positive (84.7%). In deciding upon participation, the topic of the activity was most important (n = 440, 51.4%), followed by the reputation of the presenter or the panel (n = 178, 20.8%), but not necessarily receiving accreditation or certification (n = 52, 6.1%). The survey identified several shortcomings in vascular e-Learning during the pandemic: limited possibility to attend due to lack of time and increased workload (n = 432, 50.5%), no protected/allocated time (n = 488, 57%) and no accreditation or certification, while technical shortcomings were only a minor problem (n = 25, 2.9%). CONCLUSIONS: During the COVID-19 pandemic vascular e-Learning has been used frequently and was appreciated by vascular professionals from around the globe. The survey identified strengths and weaknesses in current e-Learning that can be used to further improve online learning in vascular surgery.