P033  Demographic Factors associated with Successful Telehealth Visits in Inflammatory Bowel Disease Patients

P033  Demographic Factors associated with Successful Telehealth Visits in Inflammatory Bowel Disease Patients
 

Shah Kaustav1, Triana Austin1, Gusdorf Roman1, McCoy Allison1, Pabla Baldeep1, Scoville Elizabeth1, Dalal Robin1, Beaulieu Dawn1, Schwartz David1, Griffith Michelle1, Horst Sara2
1 Vanderbilt University, Nashville, United States, 2 Vanderbilt University Medical Center, Nashville, United States

BACKGROUND: During the SARS-CoV-2 pandemic, there was a rapid shift to telehealth for inflammatory bowel disease (IBD) care. Although past efforts with smaller populations have shown that telehealth for IBD can be cost-effective and high-quality, little was known about the effect of a systems-wide shift towards telehealth. In this study, we looked at all scheduled telehealth visits for IBD at a single institution to determine the demographics associated with telehealth use and what factors increased the chance of a technically successful visit.

METHODS: Data was collected from March - July 2020 as the adult IBD clinic was transitioned to a fully telehealth model. A protocol for telehealth was implemented including education for all staff to the telehealth connection protocol. The schedulers sent instructions to the patient through the electronic medical record (EMR). Staff called the patient within 24 hours of the visit to ensure ability for connection. A retrospective analysis was performed on all visits scheduled for this period from the IBD clinic and the overall internal medicine department using EMR data. Data was obtained on patient demographics including age, sex, and insurance status. The success of a patient visit was defined by the billing code associated with the visit. All patients were counseled on how to do a video telehealth visit through the EMR and connection to the platform Zoom. If this failed, providers attempted to conduct the visit as a phone call only encounter.

RESULTS: 2571 telehealth visits were scheduled between March and July 2020 for adult IBD patients with 2498 (99%) successfully completed by video or phone. Patients were 60% female and median age was 41 years (range 18, 91 years). 75% of the visits were conducted with patients with commercial insurance, 15% with Medicare, 5% with Medicaid, 5% with other insurance status. Video encounter completion rates from the same time period were compared between the IBD clinic and the entire internal medicine department. Patients in the IBD clinic were more likely to have a successful video encounter compared to phone only (Phone rate IBD: 313/2498 [12.5%] vs internal medicine: 8184/61725 [13.3%], p less than 0.05). Using a logistic regression model evaluating age, sex, and insurance status, increasing age (OR 1.80, [95% CI: 1.55, 2.08], p less than 0.05) and non-commercial insurance status (OR 1.89, [95% CI: 1.61, 2.21], p less than 0.05) increased the likelihood of a video encounter failure and conversion to a phone call only visit.

CONCLUSION(S): In the face of a global pandemic, there is high success rates for telehealth within an IBD population especially if clearly defined clinic protocols are put into practice to ensure success. Increasing age and non-commercial insurance status increases the risk of failure of a video visit.