Abstract
Background and Aims
The COVID-19 pandemic has highlighted the importance of telemedicine in improving healthcare access and reducing costs. This study aimed to assess order compliance in the virtual versus in-person setting for the initial evaluation of abdominal pain (AP) prior to and during the pandemic.
Methods
A retrospective evaluation of virtual and in-person outpatient gastroenterology visits for AP were identified through natural language processing from January 2019 through September 2021 at the Cleveland Clinic main campus and regional hospitals in Ohio. We assessed the number and type of orders placed for patients and measured compliance through order completion. This study received Institutional Review Board approval (IRB 21-514).
Results
Among 20,356 patients at their initial visit, 79% had orders placed, of which 40% had pandemic in-person visits, 13% had pandemic virtual visits, and 47% had pre-pandemic in-person visits. Patients seen virtually were 65.1% less likely to complete orders compared to patients seen in-person (p < 0.001) during the pandemic. Patients seen in a pandemic virtual setting were 71.0% less likely to complete imaging orders (p < 0.001), 82.6% less likely to complete procedure orders (p < 0.001), and 60.5% less likely to complete lab orders (p < 0.001).
Conclusion
Compared with in-person visits, patients seen virtually for their first presentation of AP were less likely to complete labs, imaging, and endoscopic evaluations. In-person visits were more successful with patient order completion during the pandemic. These findings highlight that virtual visits for AP, despite convenience, may compromise care delivery and warrant additional care coordination to achieve compliance with medical recommendations.
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Abbreviations
- AP:
-
Abdominal pain
- SES:
-
Socioeconomic status
- WHO:
-
World Health Organization
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Authors and Affiliations
Contributions
PS, AG, and CR were involved in designing the study protocol and data collection tool. PS, RL, and JM were involved in data collection. PS and RL were responsible for data analysis. PS was responsible for the first manuscript draft. All authors contributed to reviewing and editing the manuscript. All authors contributed to the final draft and approved this submission.
Previous presentations
Data was presented in poster form at Digestive Disease, May 2022.
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All authors declare that they have no conflicts of interest to disclose.
Ethical approval
This study was approved by the Cleveland Clinic Institutional Review Board.
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Ari Garber MD, EdD.
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Sasankan, P., McMichael, J., Lyu, R. et al. Comparative Effectiveness of Virtual Versus In-person Visits for Abdominal Pain During the COVID-19 Pandemic. Dig Dis Sci 69, 720–727 (2024). https://doi.org/10.1007/s10620-023-08236-1
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DOI: https://doi.org/10.1007/s10620-023-08236-1