As COVID-19 Shutters Practices Virtual Doc-Patient Activity Soars

Ken Terry

April 30, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A new report shows the enormous increase in online messages and virtual interactions physicians have been having with their patients ― out of necessity ― since the beginning of the COVID-19 pandemic.

The report from Luma Health, a provider of online patient engagement solutions, also shows how rapidly patients have adapted to virtual care delivery.

The report, which is based on an analysis of 5.7 million data interactions between the 300,000 healthcare professionals who use the Luma platform and their patients, shows that the providers broadcast 1.49 million text, email, and automated voice messages to patients from March 1 to April 1. This volume represents a 37-fold increase from the 69,500 messages that were delivered in January and February, before the pandemic's seriousness was generally recognized.

California providers increased the number of messages to patients by 91 times between late January and March, whereas New York clinicians sent only 16 times more messages to patients during the same period. Both states had about the same number of coronavirus cases at the beginning of March, the report states.

Practices used these messages to educate patients about precautions regarding COVID-19, to update them about clinic policies and screening procedures, to introduce new telehealth services, and to explain other changes that affect access to care.

Since late January, practices have seen a 108% increase in appointment cancellations, and appointment confirmations dropped by 43%, the report shows. The cancellation rates increased by 100% or more in the Northeast, compared to 44% in Western states.

Fifty-two percent of primary care practices reported that the cancellations had a severe or near-severe impact on them. Fifty-eight percent of primary care clinics said they'd cancelled routine wellness visits and visits for management of chronic diseases. For 83% of primary care practices, telehealth appointments were available.

The non–primary care specialty practices most affected by appointment cancellations in March were cosmetic surgery (+365%), physical therapy (+179%), radiology (121%), pulmonology (+99%), ENT (+97%), gastroenterology (+96%), multispecialty (+96%), orthopedic surgery (+90%), dermatology (+90%), and allergy (+84%).

With most nonurgent care visits being postponed, many patients, especially the 6 in 10 Americans who live with chronic diseases, have sought to reach their providers. Consequently, the phone lines in three quarters of practices have been overwhelmed.

At the same time, about 80% of patients have asked to schedule or reschedule appointments online, according to the report. More than 1 in 3 patients self-scheduled appointments after receiving automated prompts from their providers.

Previously, most physician practices were reluctant to allow patients to schedule appointments online, according to a report in Medical Economics, although many of them have encouraged patients to request appointments through their patient portals.

Providers who use Luma have pulled data from their electronic health records to identify high-risk patients and target digitized COVID-19 screenings. In addition, they are using text messages to deliver automated surveys and screenings. These methods have proved effective, especially among high-risk patients, the report states.

"The need for a quick and easy-to-use and implement telehealth solution is no longer a nice to have. As coronavirus continues to spread across the US, it's necessary to ensure seamless care for patients ― both with and without COVID-19," said Tashfeen Ekram, MD, chief medical officer at Luma Health, in a news release.

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