Evidence of a Rapid Shift in Outpatient Practice During the COVID-19 Pandemic Using Telemedicine

Introduction: During the current pandemic, measures for preventing SARS-CoV-2 virus exposure has severely impacted the delivery of outpatient clinical care to patients with a chronic neurological condition. Telemedicine has emerged as an obvious choice to counter these impediments. However, its potential for maintaining outpatient care at pre-pandemic levels during these rapidly changing times is untested. Therefore, we analyzed our experience in a tertiary care epilepsy center. Methods: We divided the study period from March 1, 2020 to April 15, 2020 into a baseline, transition (to telemedicine), and current phase. We divided outpatient encounters into clinic, virtual (using Cleveland Clinic Express Care Online platform), and telephone (including commercial video conferencing platforms). Results: Completed outpatient visits during baseline and current period were 595 and 590, respectively. Nearly 1 out of 4 patients missed outpatient visits during the transition period. The virtual visits accounted for 19.7% of completed visits during baseline and increased to 66.8% during the current period. There were no telephone visits during the baseline phase but accounted for 26.1% of completed visits during the current phase. Less than 1 percent of completed visits in the current phase were in the clinic. Conclusion: We provide evidence that telemedicine's robust and rapid scalability can help maintain a seamless transition of outpatient care during the pandemic.