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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2022; 14(02): e193-e200
DOI: 10.1055/s-0042-1756200
Research Article

Accuracy Assessment of Outpatient Telemedicine Encounters at an Academic Ophthalmology Department

Tadhg Schempf    ^
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Gagan Kalra   ^
2   Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
,
Patrick W. Commiskey
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Eve M. Bowers
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Amani Davis
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Evan L. Waxman
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Roxana Fu   *
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Andrew M. Williams   *
1   Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
› Author Affiliations Funding This work was supported by the Henry L. Hillman Foundation, National Institutes of Health (NIH) CORE Grant P30 EY08098, the Eye and Ear Foundation of Pittsburgh, and from an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology at the University of Pittsburgh. A.M.W received funding from Research to Prevent Blindness and a Mentoring for the Advancement of Physician Scientists (MAPS) award from the American Glaucoma Society. The funding organizations had no role in the design or conduct of this research.
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Abstract

Purpose We assess the clinical accuracy of direct-to-patient real-time outpatient video visit encounters at our eye center.

Design This was a retrospective longitudinal study.

Subjects and Methods Patients who completed a video visit over a 3-week period between March and April 2020 were included. Accuracy assessment was determined by comparing diagnosis and management from the video visit with subsequent in-person follow-up over the next year.

Results A total of 210 patients (mean age 55±18 years) were included, of whom 172 (82%) were recommended a scheduled in-person follow-up encounter after their video visit. Among the 141 total patients who completed in-person follow-up, 137 (97%) had a diagnostic agreement between telemedicine and in-person evaluation. Management plan agreed for 116 (82%), with the remainder of visits either escalating or deescalating treatment upon in-person follow-up with little substantive change. Compared with established patients, new patients had higher diagnostic disagreement following video visits (12 vs. 1%, p=0.014). Acute visits trended toward more diagnostic disagreement compared with routine visits (6 vs. 1%, p=0.28) but had a similar rate of management change on follow-up (21 vs. 16%, p=0.48). New patients were more likely to have early unplanned follow-up than established patients (17 vs. 5%, p=0.029), and acute video visits were associated with unplanned early in-person assessments compared with routine video visits (13 vs. 3%, p=0.027). There were no serious adverse events associated with the use of our telemedicine program in the outpatient setting.

Conclusions Video visits had high diagnostic and management agreement with subsequent in-person follow-up encounters.

Keywords

real-time telemedicine - COVID-19 pandemic - clinical accuracy of telemedicine - diagnosis and management - outpatient telemedicine - direct-to-patient

Availability of Data and Material

Available upon request.


Code Availability

Not applicable.


Ethics Approval

This retrospective longitudinal study was approved by the Institutional Review Board of the University of Pittsburgh Medical Center (STUDY20040002), adhered to the tenets of the Declaration of Helsinki and its later amendments, and maintained Health Insurance Portability and Accessibility Act (HIPAA) compliance. Informed consent was waived for this retrospective chart review.


Authors' Contribution

All authors contributed to the study conception and design. The first draft of the manuscript was written by T.S. and G.K., with additional contributions from all authors. All authors read and approved the final manuscript.


^ Equal Contribution.


* Principal Investigators.




Publication History

Received: 08 September 2021

Accepted: 16 June 2022

Article published online:
02 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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