ABSTRACT
Background: After the COVID-19 pandemic, telehealth became a vital component of the medical care for patients (pts) with liver disease. As telehealth evolves, video telehealth visits will likely be part of the future of healthcare. In this study, we evaluated the success rates and predictors for video telehealth visits for pts in general hepatology (GH) and liver transplant clinics (LTC). Methods: From April to July 2020, all visits were transitioned to telehealth at a large tertiary care referral center. This retrospective study evaluated pts with telehealth visits within GH and LTC. The clinic had a defined protocol to prepare pts for their visit. All telehealth visits were first attempted within the video conference platform Zoom with access embedded within the Electronic Medical Record (EMR). If the video telehealth visit failed, providers attempted a phone call only encounter. The primary outcome was a successful video telehealth visit. Multivariate logistic regression analysis was performed to determine factors associated with a successful video telehealth visit. Results: Between April and July 2020 1,095 telehealth visits were scheduled for adult GH and LTC pts with 1,054 visits (93%) successfully completed by either video or phone. Of successful telehealth visits, 92% were video telehealth and 8% were phone only. The median age was 56 years old and 577 (53%) were female. 53% of the visits were conducted with pts with commercial insurance, 35% with Medicare, 7% with Medicaid, and 5% with other insurance. Seventy eight percent identified as Caucasian, 4% Black, 2% Other, and 16% Unknown. Seventy eight percent of pts were seen in GH, 22% in LTC. Results of the multivariate analysis are summarized in Table 1. Increasing age range and Medicaid Insurance were associated with a higher chance of failed video telehealth visit. Sex and race were not associated with failed video telehealth visits. The same patterns persisted when restricted to either the GH or LTC visits. Conclusion: This study shows a high rate of successful video telehealth visits within general hepatology and liver transplant clinics with a defined clinic protocol for patient preparation. Our study shows increasing age and Medicaid insurance significantly increase the risk of failure to a successful telehealth video visit. This warrants more intensive pre-visit education about the video conference platform in these subgroups.