Effect of telehealth in gastroenterology (GI) clinic attendance

ABSTRACT

Introduction: Telehealth has become an important part of medical care during the COVID-19 pandemic. Previous studies have demonstrated patient preference for telehealth care due to convenience and time and cost savings related to travel. The increased ease of access for patients with telehealth may improve the attendance rate. Improving clinic attendance could increase clinic efficiency, decrease cost, and possibly improve patient outcomes. We intended to assess if telehealth in gastroenterology (GI) clinic improves the attendance rate. Methods: We performed a retrospective observational cross-sectional study using data from the electronic health record (EHR) of patients scheduled for an appointment at the adult gastroenterology/hepatology clinic from February 1st to May 1st, 2020. Continuous variables were compared using the independent t-test and categorical variables were compared using the chi-square test or Fisher's exact test, where applicable. Multivariate logistic regression analysis was performed for the missed appointment using the variable visit type as the predictor of interest and patient demographics, and appointment-related factors as covariates. Results: Of 2,258 patients scheduled for appointment, 210 (9.3%) missed their appointment. Before COVID-19 pandemic response (before March 13, 2020), all 1,133 appointments were in-person visits. During the COVID-19 era (after March 13, 2020), 806 (71.6%) appointments were televisits, conducted via telephone. In the pre-COVID era, the non-attendance rate was 7.7%;this increased to 10.9% during the COVID era (P=0.008). There was no significant difference in the non-attendance rate between televisits and in-person visits (10.7% and 8.5%;P=0.09). In the multivariate analysis, there was no significant association between visit type and attendance (adjusted odds ratio [AOR] 1.11 [0.73-1.69]). There was no significant difference in attendance before and after March 13, 2020 (AOR 1.50 [0.99-2.27]). Conclusion: The use of telehealth increased significantly during the COVID era. Televisit was not associated with an improved attendance rate in GI clinic. Further studies are needed to investigate the implications of telehealth in clinical practice..