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\begin{document}

\title{Effects of COVID-19 on Telemedicine Practice Patterns in Outpatient
Otolaryngology}



\author[1]{Jennifer Shehan}%
\author[1]{Pratima Agarwal}%
\author[2]{David Danis}%
\author[2]{Melissa Ghulam-Smith}%
\author[1]{Jacob Bloom}%
\author[1]{Jacquelyn Piraquive}%
\author[1]{Lauren Tracy}%
\author[1]{Jessica Levi}%
\affil[1]{Boston Medical Center}%
\affil[2]{Boston University School of Medicine}%


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  \date{May 18, 2024}


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\begin{abstract}
Objective: Otolaryngology is considered high risk for Coronavirus
Disease 2019 (COVID-19) exposure and spread. This has led to a
transition to telemedicine and directly impacts patient volume,
evaluation and management practices. The objective of this study is to
determine the impact of COVID-19 on patient characteristics in relation
to outpatient attendance, ancillary testing, medical therapy, and
surgical decision making. Methods: A retrospective case series at an
academic medical center was performed. Outpatient appointments from
October 2019 (pre-COVID) and March 16-April 10, 2020 (COVID) were
analyzed. Prevalence rates and odds ratios were used to compare
demographics, visit characteristics, ancillary tests, medication
prescribing, and surgical decisions between telemedicine and in-person
visits, before and during COVID. Results: There was a decrease in
scheduled visits during the COVID timeframe, for both in-person and
telemedicine visits, with a comparable proportion of no-shows. There was
a higher overall percentage of Hispanic/Latino patients who received
care during the COVID timeframe (OR = 1.43; 95\% CI = 1.07-1.90) in both
groups, although primary language was not significantly associated with
attendance. There were fewer ancillary tests ordered (OR = 0.54) and
more medications prescribed (OR = 1.59) during COVID telemedicine visits
compared with pre-COVID in-person visits. Conclusion: COVID-19 has
rapidly changed the use of telemedicine. Telemedicine can be used as a
tool to reach patients with severe disease burden. Continued healthcare
reform, expanded access to affordable care, and efficient use of
resources is essential both during the current COVID-19 pandemic and
beyond. Keywords: COVID-19, Coronavirus, Telemedicine, Otolaryngology,
Quality-improvement, Healthcare access%
\end{abstract}%



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