Biomedical Informatics

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What might the attendee be able to do after being in your session? The attendee may be able to better organize their practice in anticipation of future issues that may affect patients’ ability to present to clinic. Furthermore, the attendee may be able to better accommodate patients and provide a higher quality of care via delivery through different healthcare access modes. Description of Problem or Gap Although Telehealth use had been on a slow rise for many years, it significantly increased with the onset of the COVID-19 crisis. The stay at home orders and isolation procedures dramatically changed the way patients could access healthcare and Telehealth became a valuable tool to facilitate contactless access. The objective of this study is to elucidate how patients’ access to health care changed during the pandemic and determine if different access methods (i.e., audio-only, audio with video, or face-to-face visits) were associated with specific diagnoses or patient populations. Methods: This study is a retrospective, cross-sectional study of clinic EHR (Epic) data from the Western Michigan University Homer Stryker, M.D., School of Medicine (WMed)’s ambulatory clinic from 1/2/20-12/30/21. Microsoft Excel/Python were utilized to tabulate descriptive statistics. Results: Usage of Telehealth peaked in April 2020 at the onset of the pandemic with Audio and Video visits reaching 45.8% and 18.07% of total visits, respectively. The next three months showed Audio and Video visits decline to a steady average of 12.47% and 3.58%, respectively. Fluctuations closely followed local COVID-19 case trends. Adult Video visits were most associated with psychiatric diagnoses, while video visits were most associated with the pediatric diagnoses of developmental delay and dermatitis. While White Americans and African Americans made up 62.2% and 22% of total Office visits, respectively, Video visit proportions shifted to 73.3% for White Americans and 11.8% for Black Americans. Discussion of Results: Audio and Video visits remain as continuously utilized methods of receiving healthcare even after COVID-19 mandatory closures with increases in usage predictable during worsening public health situations. Furthermore, different healthcare modalities were utilized heavily for specific diseases. Lastly, Telehealth did show differences in usage between racial/ethnic groups indicating variation in access to healthcare. Conclusion: Telehealth has become integrated into our healthcare system, remaining a viable avenue for accessing care. Differing access patterns by different patient groups and for different predominant diagnoses suggest Telehealth carries varying value propositions in a healthcare landscape marked by inequities in access to care. Attendee’s Take-away Tool: The take-away tool is the strategy for organizing a medical practice to provide improved healthcare


Shammout A, Ziemkowski P, Kroth PJ. Patterns of telehealth usage at a medical school ambulatory practice before and during the COVID-19 pandemic. The American Medical Informatics Association Clinical Informatics Conference, Chicago, IL, May 23, 2023. (Peer Reviewed Abstract and Poster)