Do Patients Continue to Use Video Visits? Factors Related to Continued Video Visit Use.

Many studies have assessed the factors associated with overall video visit use during the COVID-19 pandemic, but little is known about who is most likely to continue to use video visits and why. The authors combined a survey with electronic health record data to identify factors affecting the continued use of video visit. In August 2020, a stratified random sample of 20,000 active patients from a large health care system were invited to complete an email survey on health care seeking preferences during the COVID. Weighted logistic regression models were applied, adjusting for sampling frame and response bias, to identify factors associated with video visit experience, and separately for preference of continued use of video visits. Actual video visit utilization was also estimated within 12 months after the survey. Three thousand three hundred fifty-one (17.2%) patients completed the survey. Of these, 1208 (36%) reported having at least 1 video visit in the past, lowest for African American (33%) and highest for Hispanic (41%). Of these, 38% would prefer a video visit in the future. The strongest predictors of future video visit use were comfort using video interactions (odds ratio [OR] = 5.30, 95% confidence interval [95% CI]: 3.57-7.85) and satisfaction with the overall quality (OR = 3.94, 95% CI: 2.66-5.86). Interestingly, despite a significantly higher satisfaction for Hispanic (40%-55%) and African American (40%-50%) compared with Asian (29%-39%), Hispanic (OR = 0.46, 95% CI: 0.12-0.88) and African American (OR = 0.54, 95% CI: 0.16-0.90) were less likely to prefer a future video visit. Disparity exists in the use of video visit. The association between patient satisfaction and continued video visit varies by race/ethnicity, which may change the future long-term video visit use among race/ethnicity groups.

Mind the clinical-analytic gap: Electronic health records and COVID-19 pandemic response.

Data quality is essential to the success of the most simple and the most complex analysis. In the context of the COVID-19 pandemic, large-scale data sharing across the US and around the world has played an important role in public health responses to the pandemic and has been crucial to understanding and predicting its likely course. In California, hospitals have been required to report a large volume of daily data related to COVID-19. In order to meet this need, electronic health records (EHRs) have played an important role, but the challenges of reporting high-quality data in real-time from EHR data sources have not been explored. We describe some of the challenges of utilizing EHR data for this purpose from the perspective of a large, integrated, mixed-payer health system in northern California, US. We emphasize some of the inadequacies inherent to EHR data using several specific examples, and explore the clinical-analytic gap that forms the basis for some of these inadequacies. We highlight the need for data and analytics to be incorporated into the early stages of clinical crisis planning in order to utilize EHR data to full advantage. We further propose that lessons learned from the COVID-19 pandemic can result in the formation of collaborative teams joining clinical operations, informatics, data analytics, and research, ultimately resulting in improved data quality to support effective crisis response.