Most pre-COVID telemed visits deemed appropriate across 5 specialties

As the COVID crisis nudges patients as well as providers to give telemedicine a try, a new study shows the option may have had momentum even if the pandemic hadn’t happened.

Looking at more than 6,500 e-consults made by 1,100 referring providers to 121 specialists—all of which took place by November 2018—researchers found more than 70% of the virtual visits met four key appropriateness criteria.

The criteria were that the clinical inquiries had to have been suitably urgent and fittingly complex while not being answerable by reviewing evidence-based summary sources or by merely requesting logistic information.

Meanwhile expert raters agreed on the appropriateness of the completed e-consults 94% of the time, according to the study abstract as published online April 14 in Annals of Internal Medicine.

In addition, the overall rate of avoided visits across the five specialties in the study—hematology, infectious disease, dermatology, rheumatology and psychiatry—topped 80% overall.

The highest rate of avoided visits was seen in psychiatry (92.6%), the lowest in dermatology (61.9%).

Researchers drew the cases from primary and specialty care practices at two large academic medical centers and two community hospitals in an integrated health system.

Lead author Salman Ahmed, MD, MPH, of Brigham and Women’s Hospital and colleagues comment that their novel metrics to assess the appropriateness and utility of e-consults “provide meaningful insight into practice, provide a rubric for comparison in future studies in additional settings, and suggest areas to improve resource use and patient care.”