Telemedicine in Otolaryngology in the COVID‐19 Era: Initial Lessons Learned

Ohlstein, Jason F.; Garner, Jordan; Takashima, Masayoshi

OBJECTIVES: The COVID‐19 pandemic has led to unprecedented global changes in the delivery of healthcare over a short period of time. With the implementation of “shelter in place” orders, otolaryngology clinic visits at our institution were transitioned to Telemedicine. This change enabled the rapid characterization of the patients who accepted and declined Telemedicine. METHODS: Review of 525 otolaryngology patients at a tertiary care referral center with scheduled visits requiring rescheduling to a future date or a Telemedicine visit. Visit, demographic information, and reason for deferring Telemedicine were collected for analysis. RESULTS: 72% of patients declined a Telemedicine visit with the most common reason being the lack of a physical exam (97%). There was an even distribution of demographics between those who accepted and declined visits. There was an association between declining Telemedicine with older age (P = 0.0004) and otology visits (P = 0.0003), while facial plastics patients were more likely to accept (P < 0.0001). Patients scheduled earlier during the pandemic were more likely to accept a visit with a median of 28 days from onset of “shelter in place” orders vs 35 for those who declined (P < 0.0001). CONCLUSIONS: We describe our initial experience with a transition to Telemedicine, where the majority of patients would decline a virtual visit due to the lack of a physical exam. While the future remains uncertain, Telemedicine will continue to play a vital role in healthcare delivery; we believe that understanding our patient base gives critical insights that will help guide and improve virtual care to meet patient's needs.