Impact of Early Telemedicine Follow-up on 30-Day Hospital Readmissions

Anne Grauer, Talea Cornelius, Marwah Abdalla, Nathalie Moise, Ian M. Kronish, Siqin Ye.

Abstract

Telemedicine is increasing in popularity but the impact of this shift on patient outcomes has not been well described. Prior data has shown that early post-discharge office visits can reduce readmissions. However, it is unknown if routine use of telemedicine visits for this purpose is similarly beneficial.

Introduction

During the COVID pandemic the landscape of ambulatory care changed. Routine appointments transitioned from traditional in-person visits to a combination of telehealth and in-person in order to decrease the spread of disease. However, the effect of this transition on clinical outcomes is still emerging.

Material and Methods:

Data extraction and patient sample

After approval by the Columbia University Institutional Review Board (IRB), we queried our EHR (Epic Systems, Verona, Wisconsin, 2020) to identify all adult, non-obstetric, and non-Covid related discharges from Columbia University Irving Medical Center (CUIMC) and NewYork-Presbyterian Allen Hospital between 6/1/2020 to 11/30/2020.

Outcomes definition

We included for analysis all discharges to home setting that also had a completed or cancelled in-person or telemedicine (including video and telephone-only) primary care (defined as an internal medicine or family medicine visit) or cardiology visit within 7 days of discharge; discharges that had readmissions prior to the scheduled follow-up visit or represented a 30-day readmission event were excluded.

Discussion

In our study of patients discharged from an academic medical center during the period immediately following the widespread telemedicine adoption, we found that those who used telemedicine follow-up visits early after discharge were no more likely to be admitted within 30 days than those whose early follow-up utilized in-person visits.

Citation: Grauer A, Cornelius T, Abdalla M, Moise N, Kronish IM, Ye S (2023) Impact of early telemedicine follow-up on 30-Day hospital readmissions. PLoS ONE 18(5): e0282081. https://doi.org/10.1371/journal.pone.0282081

Editor: Mariusz Duplaga, Uniwersytet Jagiellonski w Krakowie Biblioteka Jagiellonska, POLAND

Received: December 2, 2021; Accepted: February 8, 2023; Published: May 22, 2023.

Copyright: © 2023 Grauer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data cannot be shared publicly due to patient confidentiality. The de-identified data underlying the results presented in the study can be requested by contacting the Columbia University Irving Medical Center Institutional Review Board directly (irboffice@columbia.edu or 212-305-5883) for researchers who meet the criteria for access to confidential data.

Funding: Dr. Grauer was supported by grant numbers T32HS026121 from the Agency for Healthcare Research and Quality (https://www.ahrq.gov). Dr. Kronish received support from the Agency for Healthcare Research and Quality (R01 HS024262) and the National Heart, Lung and Blood Institute (https://www.nhlbi.nih.gov)(R01HL152699) Dr. Cornelius receives support from NIH/NCATS (https://ncats.nih.gov) (KL2 TR001874). Dr. Abdalla receives support through 18AMFDP34380732 from the American Heart Association (https://www.heart.org) and the NIH/NHLBI (K23HL141682-01A1 and R01HL146636-01A1). The content is solely the responsibility of the authors and does not necessarily represent the official view of the Agency for Healthcare Research and Quality, American Heart Association, or NIH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.