Outpatient Response
As news spread of the COVID pandemic, patients became hesitant to come
to the outpatient clinic. During the first few weeks, patients were
hesitant to participate in videoconferencing visits, however by April,
telemedicine visits became routine practice. Nationally, telemedicine
prior to COVID accounted for 0.25% of medical services provided to
Medicare beneficiaries. [9] With the emergency passage of waiver
1135 and Coronavirus Preparedness and Response Supplemental
Appropriations Act, prohibitive barriers in telemedicine were eliminated
allowing for rapid expansion to continue managing patients that are
safer at home during a pandemic. During peak telemedicine service
between March and April, 45% of all patient encounters were performed
remotely using a videoconferencing platform within our healthcare
organization. With the simultaneous interruption of cardiology and
diagnostic imaging services, new referrals during the restriction period
were limited.
An active surveillance program was initiated for all patients who had
been scheduled for surgery that had been cancelled due to hospital
restrictions. Patient check-ins were performed on a weekly basis with
videoconferencing and telephone visits to evaluate for changes in
symptoms or progression of disease necessitating more immediate
intervention.
In mid-May, as outpatient services continued ramping up, the two-month
backlog of patients who had declined telemedicine visits started to
return for follow up. Currently, chronic aortic dissection and aortic
aneurysm patients have been the most challenging to recapture, with 30%
requesting deferral of their routine imaging to a later date.