Assessing Telehealth Through the Lens of the Provider: Considerations for the Post-COVID-19 Era.

Introduction: Following the coronavirus disease (COVID-19) pandemic restrictions, many health care systems turned to telehealth as an alternative to in-person care. Current literature describes sustained patient satisfaction levels with virtual care throughout the pandemic era. However, provider opinions on the transforming landscape are largely unknown. Objectives: The aim of this study is to better understand provider intentions and limitations to telehealth adoption, along with preferences by various specialties and in various settings. Methods: A mixed-methods study design was used. An attitudinal survey was sent to 2,633 health care providers at a large, quaternary, integrated health system. The survey collected deidentified quantitative and qualitative data on factors influencing provider use, satisfaction, and concerns with telehealth during and after the initial pandemic-era restrictions. Results: Five hundred eighteen providers participated in the survey. Utilization of telehealth was largely motivated by (1) improving patient access (mean 29.3%; range 28-31.6%) and (2) patient interest (mean 23%; range 17.1-28.8%). Barriers included (1) technology limitations (mean 16.1%; range 12.4-23.8%) and (2) reimbursement uncertainties (mean 15.2%; range 4.8-18.8%). Preference for virtual care was reported to be highest in ambulatory settings, including direct-to-patient care and outpatient care. Discussion: Provider preference for telehealth, regardless of specialty or health care setting, revolves around a consumer-centric care delivery model, with increased access to care being a central theme. While provider values are patient oriented, this study found that concerns included connectivity, quality, and patient privacy. Amid changing care standards and regulations, provider preference is supportive of virtual care platforms, both now and postpandemic.

Quantifying the decrease in emergency department imaging utilization during the COVID-19 pandemic at a multicenter healthcare system in Ohio.

PURPOSE: To illustrate the change in emergency department (ED) imaging utilization at a multicenter health system in the state of Ohio during the COVID-19 pandemic. METHODS: A retrospective observational study was conducted assessing ED imaging volumes between March 1, 2020, and May 11, 2020, during the COVID-19 crisis. A rolling 7-day total value was used for volume tracking and comparison. Total imaging utilization in the ED was compared with new COVID-19 cases in our region. Utilization was first categorized by modality and then by plain films and computed tomography (CT) scans grouped by body part. CT imaging of the chest was specifically investigated by assessing both CT chest only exams and CT chest, abdomen, and pelvis (C/A/P) exams. Ultimately, matching pair-wise statistical analysis of exam volumes was performed to assess significance of volume change. RESULTS: Our multicenter health system experienced a 46% drop in imaging utilization (p < 0.0001) during the pandemic. Matching pair-wise analysis showed a statistically significant volume decrease by each modality and body part. The exceptions were non-contrast chest CT, which increased (p = 0.0053), and non-trauma C/A/P CT, which did not show a statistically significant volume change (p = 0.0633). CONCLUSION: ED imaging utilization trends revealed through actual health system data will help inform evidence-based decisions for more accurate volume predictions and therefore institutional preparedness for current and future pandemics.

COVID-19 Pandemic Impact on Decreased Imaging Utilization: A Single Institutional Experience.

RATIONALE AND OBJECTIVES: Predictive models and anecdotal articles suggest radiology practices were losing 50%-70% of their normal imaging volume during the COVID-19 pandemic. Using actual institutional data, we investigated the change in imaging utilization and revenue during this public health crisis. MATERIALS AND METHODS: Imaging performed within the 8-week span between March 8 and April 30, 2020 was categorized into the COVID-19 healthcare crisis timeframe. The first week of this date range and the 10 weeks prior were used to derive the normal practice expected volume. A rolling 7-day total value was used for volume tracking and comparison. Total imaging utilization was derived and organized by patient setting (outpatient, inpatient, emergency) and imaging modality (X-ray, CT, Mammography, MRI, Nuclear Medicine/PET, US). The three highest volume hospitals were analyzed. Revenue information was collected from the hospital billing system. RESULTS: System-wide imaging volume decreased by 55% between April 7 and 13, 2020. Outpatient exams decreased by 68% relative to normal practice. Emergency exams decreased by 48% and inpatient exams declined by 31%. Mammograms and nuclear medicine scans were the most affected modalities, decreasing by 93% and 61%, respectively. The main campus hospital experienced less relative imaging volume loss compared to the other smaller and outpatient-driven hospitals. At its lowest point, the technical component revenue from main campus imaging services demonstrated a 49% negative variance from normal practice. CONCLUSION: The trends and magnitude of the actual imaging utilization data presented will help inform evidence-based decisions for more accurate volume predictions, policy changes, and institutional preparedness for current and future pandemics.