RT Journal Article
SR Electronic
T1 Comparing Outcomes of Musculoskeletal Radiographs from In-Person and Telemedicine Primary Care Cohorts, April 2019–June 2021
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 739
OP 745
DO 10.3122/jabfm.2023.230094R1
VO 36
IS 5
A1 Petrilli, John
A1 Guth, Taylor
A1 Coughlin, Emily
YR 2023
UL http://www.jabfm.org/content/36/5/739.abstract
AB Purpose: Musculoskeletal conditions are a common reason for primary care visits, and they are being increasingly addressed at televisits. We therefore examined outcomes of musculoskeletal radiographs ordered at in-person and telemedicine primary care visits, which have implications for patient care and the economic impact of telemedicine.Methods: We performed a retrospective cohort study of musculoskeletal radiograph orders placed April 1, 2019–March 31, 2021 at a major academic health system. Radiology reports were classified as normal or abnormal based on the radiologist’s impression. Findings were compared using c2 tests.Results: The main outcome was radiographic abnormalities. A secondary outcome was the effect of social determinants of health and medical comorbidities on telemedicine utilization. A total of 1580 radiographs were reviewed. Compared with televisits occurring after onset of the SARS-Cov2-19 pandemic, radiographs ordered at in-person visits had higher odds of being abnormal (OR 2.51, 95% CI 1.33–4.75; P = .004). When comparing radiographic outcomes at in-person visits before and after the pandemic’s onset, those ordered afterward had higher odds of being abnormal (OR 1.88, 95% CI 1.30–2.71; P < .001). Social determinants of health and medical comorbidities were not associated with telemedicine utilization.Conclusions: After the onset of the SARS-Cov2-19 pandemic, radiographs ordered at in-person visits had higher odds of being abnormal compared with televisits. These findings indicate that prudence should be applied to ordering musculoskeletal radiographs in telemedicine encounters.