Factors Associated with Increased Risk of Patient No-Show in Telehealth and Traditional Surgery Clinics

Kemp, Michael T.; Liesman, Daniel; Brown, Craig; Williams, Aaron M.; Biesterveld, Ben E.; Wakam, Glenn K.; Wilson, Jesse K.; Alam, Hasan B.

doi:10.1016/j.jamcollsurg.2020.08.760

Cited by 29 publications

(34 citation statements)

References 17 publications

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“…After adjusting for telemedicine use, the likelihood of missed appointments varied by race and ethnicity, with African American and Hispanic patients reporting 61% and 19% higher odds compared to Whites. This finding aligns with previous studies reporting that Hispanic [ 14 ] and African American [ 15 ] patients are more likely to miss appointments. This trend is concerning, suggesting that telemedicine is not an all-encompassing solution for missed appointments, and points to more pressing issues.…”

Section: Discussionsupporting

confidence: 92%

“…In primary care, the most common reasons for missing appointments are forgetfulness and miscommunication with clinic staff [ 14 ]. While these earlier studies have formed a great foundation in the effort to reduce inefficiencies associated with missed appointments, few [ 15 , 16 ] have examined the impact of telemedicine use on missed appointments. Investigating this role of telemedicine is particularly noteworthy because of its suggested potential in reducing missed appointments.…”

Section: Introductionmentioning

confidence: 99%

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Transition to telemedicine and its impact on missed appointments in community-based clinics

et al. 2021

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Background and objective The Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relationship between telemedicine usage and missed appointments during the COVID-19 pandemic. Method This retrospective study used appointment-level data from 55 Federally Qualified Health Centre clinics in Texas between March and November 2020. To account for the nested data structure of repeated appointments within each patient, a mixed-effects multivariable logistic regression model was used to examine associations between telemedicine use and missed appointments, adjusting for patient sociodemographic characteristics, geographic classification, past medical history, and clinic characteristics. The independent variable was having a telemedicine appointment, defined as an audiovisual consultation started and finalized via a telemedicine platform. The outcome of interest was having a missed appointment (yes/no) after a scheduled and confirmed medical appointment. Results from this initial model were stratified by appointment type (in-person vs. telemedicine). Results The analytic sample included 278,171 appointments for 85,413 unique patients. The overall missed appointment rate was 18%, and 25% of all appointments were telemedicine appointments. Compared to in-person visits, telemedicine visits were less likely to result in a missed appointment (OR = 0.87, p < .001). Compared to Whites, Asians were less likely to have a missed appointment (OR = 0.82, p < .001) while African Americans, Hispanics, and American Indians were all significantly more likely to have missed appointments (OR = 1.61, p < .001; OR = 1.19, p = .01; OR = 1.22, p < .01, respectively). Those accessing mental health services (OR = 1.57 for in-person and 0.78 for telemedicine) and living in metropolitan areas (OR = 1.15 for in-person and 0.82 for telemedicine) were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Patients with frequent medical visits or those living with chronic diseases were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Conclusions Telemedicine is strongly associated with fewer missed appointments. Although our findings suggest a residual lag in minority populations, specific patient populations, including those with frequent prior visits or chronic conditions, those seeking mental health services, and those living in metropolitan areas were less likely to miss telemedicine appointments than in-person visits. These findings highlight how telemedicine can enable effective and accessible care by re...

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Transition to telemedicine and its impact on missed appointments in community-based clinics

et al. 2021

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“…One of the most frequent deciding factors whether to choose a TME versus in-person visit in the future for both groups was the need for a physical exam. These findings are consistent with previous TME surveys, including surgical subspecialties, which have demonstrated lack of PE as a barrier to TME use [3,[17][18][19][20]. Recently, several studies have published guidelines on physical examination during TMEs [21,22].…”

Section: Discussionsupporting

confidence: 90%

Surgeon, patient, and caregiver perspective of pediatric surgical telemedicine in the COVID-19 pandemic era

et al. 2021

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Purpose Adoption of telemedicine (TME) in surgical specialties, prior to the COVID-19 pandemic, has previously been slow. The purpose of this prospective, observational, single institution study is to evaluate surgeon and caregiver perspectives of TMEs during the pandemic. Methods Surveys were distributed to surgical faculty regarding perceptions of TME early during the pandemic and 2 months later. Caregivers (or patients > 18 years old) were asked after each TME to complete a survey regarding perceptions of TMEs. Results Surveys were distributed to 73 surgeons. Response rates were 71% initially and 63% at follow-up. Sixty-eight percent reported no prior TME experience. No significant differences were noted in the overall satisfaction. An inverse relationship between surgeon age and satisfaction at the follow-up survey was identified ( p = 0.007). Additional surveys were distributed to 616 caregivers or patients (response rate 13%). Seventy-two percent reported no prior experience with TME and 79% described TME as similar to an in-person visit. Audiovisual satisfaction of the TME was higher in greater income households ( p = 0.02). Conclusions Pre-pandemic experience with TME was low in both groups; however, experiences were perceived as satisfactory. Positive experiences with TME may encourage increased utilization in the future, although demographic variations may impact satisfaction with TME. Trial registration Unique identifier NCT04376710 at Clinicaltrials.gov (5/6/2020).

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“…This suggests an overall improvement in prenatal care access. Given that the literature on missed appointment rates in telemedicine versus in‐person visits is inconclusive outside of this review 39–41 and prioritizing essential visits during the COVID‐19 pandemic may inadvertently skew studies assessing virtual visit attendance during the pandemic, findings from this review suggest that improved rates of attendance at virtual visits merits further investigation. Reminder calls and texts did improve visit attendance 18 .…”

Section: Discussionmentioning

confidence: 98%

Virtual Visits in Prenatal Care: An Integrative Review

López

Nichols

2021

J Midwife Womens Health

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Introduction Addressing gaps in access to prenatal care is an important step to reversing rising rates of maternal and neonatal morbidity and mortality and invites the exploration of innovative care models. This integrative review of published literature explores the patient, health care provider, and organizational experience of integrating virtual visits in prenatal care. Methods A literature search to identify original studies and quality improvement projects published between 2010 and 2020 was conducted in PubMed, Scopus, CINAHL, and Google Scholar using keywords associated with both telemedicine and prenatal care. Inclusion criteria specified articles pertaining to synchronous virtual visits between pregnant patients and health care providers, and articles were excluded if visits were not pregnancy‐centric or pertaining to telemonitoring or mobile applications. Reference lists of identified reviews were screened, and a hand search of 4 applicable journals was also conducted. Findings were organized according to the factors of the social ecological model: individual, interpersonal, organizational, community, and public policy. Results The search identified 2666 articles after duplicates were removed, of which 13 met all criteria. Findings across these 13 articles indicated strong patient and health care provider satisfaction with virtual care related to cost savings and convenience, with clinic wait times and cancellation rates also improving. Health care provider input and thoughtful organizational planning were key to a smooth telemedicine implementation process. There were notably no significant differences in clinical outcomes for those who used virtual care. Discussion Although data are limited, offering an integrated model that uses both virtual visits and in‐person visits has been well‐received by patients and health care providers and could improve access to care well into the future. Virtual visits in prenatal care have been well‐received by patients and health care providers, showing promise as an emerging model for improving access to care.

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Factors Associated with Increased Risk of Patient No-Show in Telehealth and Traditional Surgery Clinics

Cited by 29 publications

References 17 publications

Transition to telemedicine and its impact on missed appointments in community-based clinics

Transition to telemedicine and its impact on missed appointments in community-based clinics

Surgeon, patient, and caregiver perspective of pediatric surgical telemedicine in the COVID-19 pandemic era

Virtual Visits in Prenatal Care: An Integrative Review

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