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Patient experience after modifying visit delivery during the COVID-19 pandemic.

Authors :: Miller MJ
Watson ES
Horberg MA
Bhatia M
Tripuraneni BR
McCarthy RJ
Source :: The American journal of managed care [Am J Manag Care] 2021 Feb 01; Vol. 27 (2), pp. e54-e63. Date of Electronic Publication: 2021 Feb 01.
Publication Year :: 2021
Abstract: Objectives: To describe real-time changes in medical visits (MVs), visit mode, and patient-reported visit experience associated with rapidly deployed care reorganization during the coronavirus disease 2019 (COVID-19) pandemic.<br />Study Design: Cross-sectional time series from September 29, 2019, through June 20, 2020.<br />Methods: Responding to official public health and clinical guidance, team-based systematic structural changes were implemented in a large, integrated health system to reorganize and transition delivery of care from office-based to virtual care platforms. Overall and discipline-specific weekly MVs, visit mode (office-based, telephone, or video), and associated aggregate measures of patient-reported visit experience were reported. A 38-week time-series analysis with March 8, 2020, and May 3, 2020, as the interruption dates was performed.<br />Results: After the first interruption, there was a decreased weekly visit trend for all visits (β3 = -388.94; P < .05), an immediate decrease in office-based visits (β2 = -25,175.16; P < .01), increase in telephone-based visits (β2 = 17,179.60; P < .01), and increased video-based visit trend (β3 = 282.02; P < .01). After the second interruption, there was an increased visit trend for all visits (β5 = 565.76; P < .01), immediate increase in video-based visits (β4 = 3523.79; P < .05), increased office-based visit trend (β5 = 998.13; P < .01), and decreased trend in video-based visits (β5 = -360.22; P < .01). After the second interruption, there were increased weekly long-term visit trends for the proportion of patients reporting "excellent" as to how well their visit needs were met for all visits (β5 = 0.17; P < .01), telephone-based visits (β5 = 0.34; P < .01), and video-based visits (β5 = 0.32; P < .01). Video-based visits had the highest proportion of respondents rating "excellent" as to how well their scheduling and visit needs were met.<br />Conclusions: COVID-19 required prompt organizational transformation to optimize the patient experience.