Impact of COVID-19 lockdown on patient-provider electronic communications

Abstract

Background SARS CoV-2 virus (COVID-19) impacted the practice of healthcare in the United States, with technology being used to facilitate access to care and reduce iatrogenic spread. Since then, patient message volume to primary care providers has increased. However, the volume and trend of electronic communications after lockdown remain poorly described in the literature. Methods All incoming inbox items (telephone calls, refill requests, and electronic messages) sent to providers from patients amongst four primary care clinics were collected. Inbox item rates were calculated as a ratio of items per patient encountered each week. Trends in inbox rates were assessed during 12 months before and after lockdown (March 1st, 2020). Logistic regression was utilized to examine the effects of the lockdown on inbox item rate post-COVID-19 lockdown as compared to the pre-lockdown period. Results Before COVID-19 lockdown, 2.07 new inbox items per encounter were received, which increased to 2.83 items after lockdown. However, only patient-initiated electronic messages increased after lockdown and stabilized at a rate higher than the pre-COVID-19 period (aRR 1.27, p-value < 0.001). In contrast, prescription refill requests and telephone calls quickly spiked, then returned to pre-lockdown levels. Conclusion Based on our observations, providers experienced a quick increase in all inbox items. However, only electronic messages had a sustained increase, exacerbating the workload of administrators, staff, and clinical providers. This study directly correlates healthcare technology adoption to a significant disruptive event but also shows additional challenges to the healthcare system that must be considered with these changes.

Preferred sources of information on diabetes prevention programmes: a population-based cross-sectional study in Poland

“…This tendency was predicted over 20 years ago [34][35][36] and has been further accelerated by the COVID-19 pandemic. [37][38][39] Variable/source of information Open access…”

The Impact of COVID‐19 on Education and Training in Rheumatology: A Narrative Review

“…In addition, providers have been increasingly tasked with addressing complex patient medical advice requests during the pandemic (doubling from prepandemic levels in most specialties), often as a means to reduce the need for in-person evaluation. [32][33][34] Studies investigating the impact of this growth on trainees specifically are lacking, but it stands to reason they would be affected similarly to practicing physicians in the absence of programs that otherwise shield them from this work. Indeed, the impact may be more profound among trainees compared to experienced physicians.…”

“…This includes requests for pharmacy refills, review of labs and outside medical records, and communication with consulting physicians. In addition, providers have been increasingly tasked with addressing complex patient medical advice requests during the pandemic (doubling from prepandemic levels in most specialties), often as a means to reduce the need for in‐person evaluation 32–34 . Studies investigating the impact of this growth on trainees specifically are lacking, but it stands to reason they would be affected similarly to practicing physicians in the absence of programs that otherwise shield them from this work.…”