The following is a summary of “Telemedicine and Resource Utilization in Pulmonary Clinic,” published in the June 2024 issue of Pulmonology by Puthumana et al.
The COVID-19 pandemic catalyzed a significant surge in telemedicine usage, yet its impact on resource utilization within pulmonary clinics remains uncertain. This retrospective cohort study analyzed adult patients who visited the pulmonary clinics at the University of Miami Hospital and Clinics between January 2018 and December 2021. The primary objective was to compare resource use between telemedicine and in-person visits. Standard statistical methods were employed to characterize the patient cohort and compare resource utilization based on the visit type, with multivariable logistic regression models assessing the association of telemedicine with specific resource usage, notably computed tomography (CT) orders within seven days post-visit.
The study encompassed 21,744 clinic visits, with 5,480 (25.2%) conducted via telemedicine and 16,264 (74.8%) in person. The patient demographics revealed a majority under 65 years of age, predominantly female, and identifying as Hispanic white across both visit types. Analysis indicated that telemedicine visits were associated with higher odds of CT scan orders within seven days (adjusted odds ratio [aOR] 1.34, 95% CI 1.04–1.74) but lower odds of chest x-ray orders (aOR 0.37, 95% CI 0.23–0.57). Additionally, telemedicine visits were linked to increased odds of patient contact with the healthcare system within 30 days (aOR 1.56, 95% CI 1.29–1.88) and 90 days (aOR 1.39, 95% CI 1.17–1.64). Notably, these visits were associated with reduced odds of emergency department visits and hospitalizations at 30 days (aOR 0.54, 95% CI 0.38–0.76) and 90 days (aOR 0.68, 95% CI 0.52–0.89) but significantly higher odds of follow-up phone calls and electronic health record inbox messages at 30 days (aOR 3.44, 95% CI 2.73–4.35) and 90 days (aOR 3.58, 95% CI 2.95–4.35).
In conclusion, telemedicine was associated with increased CT scan orders and decreased chest x-ray orders. Moreover, it led to greater patient engagement with the healthcare system, potentially imposing a heavier time burden on outpatient clinicians. The findings underscore the nuanced impact of telemedicine on healthcare resource utilization, necessitating further exploration into optimizing telehealth practices to balance resource use and clinician workload effectively.
Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03066-x
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