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.