Assessing the Impact of a Rapidly Scaled Virtual Urgent Care in New York City During the COVID19 Pandemic

Koziatek, Christian A.; Rubin, Ada; Lakdawala, Viraj; Lee, David C.; Swartz, Jordan; Auld, Elizabeth; Smith, Silas W.; Reddy, Harita; Jamin, Catherine; Testa, Paul; Femia, Robert; Caspers, Christopher

Abstract Background The COVID-19 pandemic quickly challenged New York City healthcare systems. Telemedicine has been suggested to manage acute complaints and divert patients from in-person care. Objectives The objective of this study was to describe and assess the impact of a rapidly scaled virtual urgent care during the COVID-19 pandemic. Methods This was a retrospective cohort study of all patients who presented to a virtual urgent care platform over one month during the COVID-19 pandemic surge. We described scaling our telemedicine urgent care capacity, described patient clinical characteristics, assessed for emergency department (ED) referrals, and analyzed post-visit surveys. Results During the study period, a total of 17,730 patients were seen via virtual urgent care. 454 (2.56%) were referred to an ED. The most frequent diagnoses were COVID-19 related or upper respiratory symptoms. Geospatial analysis indicated a wide catchment area. 251 providers were onboarded to the platform; at peak, 62 providers supplied 364 hours of coverage in one day. The average patient satisfaction score was 4.4/5. 2,668 patients (15.05%) responded to the post-visit survey; 1,236 (49.35%) would have sought care in an ED (11.86%) or in-person urgent care (37.49%). Conclusions A virtual urgent care was scaled to manage a volume of more than 800 patients a day across a large catchment area during the pandemic surge. About half of patients would have otherwise presented to an ED or urgent care in-person. Virtual urgent care is an option for appropriate patients while minimizing in-person visits during the COVID-19 pandemic.