Multi-center evaluation of telehealth utilization in hip and knee arthroplasty from prior to and for one-year during the COVID-19 pandemic

Bini, Stefano; Chiu, Yu-Fen; Ast, Michael; Krueger, Chad; Maratt, Joseph; Bendich, Ilya

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has led to an increase in telehealth utilization across healthcare. It is unknown if telehealth use among hip and knee arthroplasty clinics has remained an important healthcare delivery platform. The purpose of the present study was to analyze telehealth utilization prior to and for one-year during the pandemic among four, varied hip and knee arthroplasty clinics. METHODS: Retrospective data was available from four, regionally diverse hip and knee arthroplasty centers. Data on volume of patient visits, demographics, visit types (new visit, follow-up, postoperative visit, other), visit modality (in-person, telehealth, telephone) was available from January 2020 through April 2021. Data from the centers was analyzed as a total and separately, using Chi-squared and Fisher exact tests. RESULTS: Among the four centers, there were 296,540 hip and knee arthroplasty outpatient clinic visits between January 2020 through April 2021. Of those, 15,240 (5%) were telehealth visits. Prior to March 2020, less than 0.1% of visits across centers occurred over telehealth. The highest utilization of telehealth visits occurred in March 2020 (>55%) and April 2020 (>25%). From August 2020 until April 2021, telehealth visits accounted for 2-3% of total visits. Younger patients (<50 years old) were most likely to utilize telehealth. Follow-up and postoperative were the most likely telehealth visits. CONCLUSION: Telehealth utilization peaked during March and April of 2020 and has since reverted to near pre-pandemic levels. Younger patients and lower complexity visits such as postoperative or follow-up visits are more likely to utilize telehealth.