Derjung Mimi Tarn, MD, PhD; Courtney Hintz, MD; Eluar Mendez-Hernandez, MD; Sabrina P. Sawlani, DO; Michelle A. Bholat, MD, MPH
Corresponding Author: Derjung Mimi Tarn, MD, PhD; David Geffen School of Medicine at UCLA. Email: dtarn@mednet.ucla.edu
Section: Brief Report
Purpose: Examine utilization of office resources by primary care patients who were initially evaluated through telehealth, telephone, or in-person encounters. Methods: Retrospective electronic health record review on 202 patients seen from March 3-31, 2020 in a large California academic family medicine practice for evaluation of potential COVID-19 symptoms, to assess the total number of interactions (electronic messaging, telehealth, telephone, and in-person office encounters) with physicians and office staff. Results: Of 202 patients, 89 (44%) had initial telehealth, 55 (27%) telephone, and 52 (25%) inperson encounters. Patients initially evaluated through telehealth, telephone and in-person encounters had a mean of 6.1 (SD=3.7), 5.2 (SD=3.6), 4.5 (SD=3.0) total interactions with the office, respectively (p=0.03), and 9%, 12.7%, and 19.2%, respectively, had a subsequent inperson or emergency department visit (p=0.22). Five patients who tested positive for COVID-19 were all initially evaluated via telehealth; one required subsequent hospitalization. Of all patients presenting for care, 78% reported having a cough. Multivariable analysis showed no differences in number of office interactions based on visit type; older patients (95% CI=0.00-0.07) and those with subjective fevers (95% CI=1.01-3.01) or shortness of breath (95% CI=0.23-2.28) had more interactions with the office. Conclusion: Primary care providers utilized virtual visits to care for most patients presenting with potential COVID-19 symptoms, with many patients choosing telephone over telehealth visits. Virtual visits can successfully limit patient exposure to other people, and consideration could be given to increasing its use for patients with potential symptoms of COVID-19.