Factors to Consider for Successful Telemedicine Gastroenterology Subspecialty Visits in Disparate Populations

Introduction: Telemedicine was put at the forefront of the healthcare delivery process during the coronavirus disease 2019 (COVID-19) pandemic. Pre-COVID-19 research had shown telemedicine to be beneficial in the gastroenterology field with improved quality of life and reduced healthcare cost in the IBD population. However, telemedicine remained underutilized in subspecialty care with constraints at both provider and patient level. Objective: To analyze the telemedicine encounters in a gastroenterology clinic at a tertiary care hospital and identify factors that facilitate or limit the use of telemedicine modalities. Methods: The project was a retrospective, single-center study with continuous sampling of one hundred and fifty-three patients who scheduled one hundred and fifty-eight telemedicine encounters that included both Inflammatory Bowel Disease (IBD) and general gastroenterology patients. We examined the influence of age, sex, race, geographic location and payer source, on audio or video telemedicine encounters, as well as the show rate. Results: Our study showed a promising show rate of 90.5% with a majority of the patients preferring video over audio visits; however, increasing age proved to be a barrier in successfully completing video visits. In total, 26.2% of the patients who desired video encounters had to be switched to audio only. We found that race, sex, payor source, and living in a rural zip code did not influence the rate of completed telemedicine encounters or the patients’ preferred modality (audio vs video). Conclusion: The recurring COVID-19 surge due to different variants provides an opportunity to refine the telemedicine experience in our healthcare. Telemedicine encounters have a promising role in gastroenterology outpatient care and can be utilized to improve access to care and bridge healthcare disparities. In order to increase compliance further work needs to be done to make the digital platform user friendly for the elderly population.