1. Telemedicine impact on post-stroke outpatient follow-up in an academic healthcare network during the COVID-19 pandemic.
- Author
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Alabyad D, Lemuel-Clarke M, Antwan M, Henriquez L, Belagaje S, Rangaraju S, Mosley A, Cabral J, Walczak T, Ido M, Hashima P, Bayakly R, Collins K, Sutherly-Bhadsavle L, Brasher C, Danaie E, Victor P, Westover D, Webb M, Skukalek S, Barrett AM, Esper GJ, and Nahab F
- Subjects
- Humans, Outpatients, Retrospective Studies, SARS-CoV-2, Pandemics, Delivery of Health Care, COVID-19 epidemiology, Telemedicine, Stroke diagnosis, Stroke epidemiology, Stroke therapy
- Abstract
Background: The expansion of telemedicine associated with the COVID-19 pandemic has influenced outpatient medical care. The objective of our study was to determine the impact of telemedicine on post-acute stroke clinic follow-up., Methods: We retrospectively evaluated the impact of telemedicine in Emory Healthcare, an academic healthcare system of comprehensive and primary stroke centers in Atlanta, Georgia, on post-hospital stroke clinic follow-up. We compared the frequency of 90-day follow-up in a centralized subspecialty stroke clinic among patients hospitalized before the local COVID-19 pandemic (January 1, 2019- February 28, 2020), during (March 1- April 30, 2020) and after telemedicine implementation (May 1- December 31, 2020). A comparison was made across hospitals less than 1 mile, 10 miles, and 25 miles from the stroke clinic., Results: Of 1096 ischemic stroke patients discharged home or to a rehab facility during the study period, 342 (31%) had follow-up in the Emory Stroke Clinic (comprehensive stroke center 46%, primary stroke center 10 miles away 18%, primary stroke center 25 miles away 14%). Overall, 90-day follow-up increased from 19% to 41% after telemedicine implementation (p<0.001) with telemedicine appointments amounting for up to 28% of all follow-up visits. In multivariable analysis, factors associated with teleneurology follow-up (vs no follow-up) included discharge from the comprehensive stroke center, thrombectomy treatment, private insurance, private transport to the hospital, NIHSS 0-5 and history of dyslipidemia., Conclusions: Despite telemedicine implementation at an academic healthcare network successfully increasing post-stroke discharge follow-up in a centralized subspecialty stroke clinic, the majority of patients did not complete 90-day follow-up during the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest There were no unusual circumstances surrounding the research, nor were there deviations from standard procedures or format. There is no funding or financial support to disclose., (Copyright © 2023. Published by Elsevier Inc.)
- Published
- 2023
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