Accuracy Assessment of Outpatient Telemedicine Encounters at an Academic Ophthalmology Department

Authors

Tadhg Schempf, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Gagan Kalra, Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
Patrick W. Commiskey, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Eve M. Bowers, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Amani Davis, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Evan L. Waxman, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Roxana Fu, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Andrew M. Williams, Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Abstract

Abstract

Purpose We assess the clinical accuracy of direct-to-patient real-time outpatient video visit encounters at our eye center.

Design This was a retrospective longitudinal study.

Subjects and Methods Patients who completed a video visit over a 3-week period between March and April 2020 were included. Accuracy assessment was determined by comparing diagnosis and management from the video visit with subsequent in-person follow-up over the next year.

Results A total of 210 patients (mean age 55±18 years) were included, of whom 172 (82%) were recommended a scheduled in-person follow-up encounter after their video visit. Among the 141 total patients who completed in-person follow-up, 137 (97%) had a diagnostic agreement between telemedicine and in-person evaluation. Management plan agreed for 116 (82%), with the remainder of visits either escalating or deescalating treatment upon in-person follow-up with little substantive change. Compared with established patients, new patients had higher diagnostic disagreement following video visits (12 vs. 1%, p=0.014). Acute visits trended toward more diagnostic disagreement compared with routine visits (6 vs. 1%, p=0.28) but had a similar rate of management change on follow-up (21 vs. 16%, p=0.48). New patients were more likely to have early unplanned follow-up than established patients (17 vs. 5%, p=0.029), and acute video visits were associated with unplanned early in-person assessments compared with routine video visits (13 vs. 3%, p=0.027). There were no serious adverse events associated with the use of our telemedicine program in the outpatient setting.

Conclusions Video visits had high diagnostic and management agreement with subsequent in-person follow-up encounters.

Received Date

September 8, 2021

Accepted Date

June 16, 2022

Online Available Date

September 2, 2022

Recommended Citation

Schempf, Tadhg; Kalra, Gagan; Commiskey, Patrick W.; Bowers, Eve M.; Davis, Amani; Waxman, Evan L.; Fu, Roxana; and Williams, Andrew M. (2022) "Accuracy Assessment of Outpatient Telemedicine Encounters at an Academic Ophthalmology Department," Journal of Academic Ophthalmology: Vol. 14: Iss. 2, Article 18.
DOI: 10.1055/s-0042-1756200
Available at: https://www.aupojournal.org/jao/vol14/iss2/18