Prolonged follow up: The impact of telehealth implementation in a urology clinic during the Covid-19 pandemic
Trent Pattenden1, Isaac Thangasamy1.
1Urology, Ipswich Hospital, Ipswich, Australia
Introduction: Prior to the Covid-19 pandemic, use of telehealth in urology was lower than other specialties. Widespread adoption of telehealth began April 2020 as a physical distancing measure. Restrictions on in-person encounters ended October 2020. This study aims to define the effect of telehealth on encounter outcomes in a urology outpatient clinic.
Methods: Urology outpatient clinic encounters at Ipswich Hospital, Queensland between July 2019-Decemebr 2020 were retrospectively reviewed. Telehealth impact was assessed by comparing outcomes for different encounter modalities from October-December 2020 with those prior to telehealth implementation (July - December 2019). Bonferroni corrected goodness of fit Chi-Square tests were used for inferential statistics.
Results: Encounters increased 24% between Q3 2019 (n=1208) and Q4 2020 (n=1514) (Figure 1). 84% (n=1120) of all Q2 2020 encoutners were telehealth. 58% of Q4 2020 encounters were still conducted via telehealth despite no restrictions. When comparing Q4 2020 outcomes to those before implementing telehealth (July - December 2019), significantly more patients were booked for further follow up from all encounter types; this relationship was strongest for new (χ2=130.04,p<.003) and review (χ2=664.62,p<.003) phone encounters (Table 1). Signifcantly more patient attending in-person review encounters were booked for an elective operation (χ2=16.68,p<.003) (Table 2). Significantly more patients were discharged from clinic when attending phone (χ2=27.35,p<.003) (Table 3) compared with prior to telehealth implementation.
Conclusions: The largest change in outcomes after telehealth implementation was an increase the number of future review appointments booked. More work in patient selection for telehealth is needed to reduce inefficiencies with this model of care.
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