Author Of 1 Presentation
LB1273 - Telehealth Utilization in Four MS Centers During the COVID Pandemic: Real-world evidence from the MS-CQI improvement research collaborative. (ID 2172)
Abstract
Background
MS-CQI is the first multi-center improvement research collaborative for MS care. MS-CQI is a three-year study (2018-2020) to evaluate system-level performance variation and improve MS population health outcomes. Four MS centers are participating, following approximately 5,000 people with MS. The COVID pandemic onset occurred approximately half-way through the third year of the study. Prior to this time, telehealth was not utilized in participating MS-CQI centers, but after COVID onset, MS-CQI centers began utilizing telehealth in various ways. In response to this development, measures of telehealth utilization were collected in order to study system level variation in telehealth utilization for COVID-era MS care during the last 6 months of the MS-CQI study.
Objectives
To describe system-level variation in MS clinical care utilization by type (in-person visit, telephone visit, or video telehealth visit) for the last six months of the MS-CQI study (January-June 2020) during the COVID pandemic.
Methods
Electronic Health Record (EHR) data from clinical encounters at the four participating MS-CQI centers was abstracted for January-June 2020. Participants were adults ≥18 years with MS. Telehealth utilization was categorized into three types: (1) “in-person” (standard clinical visit); (2) “telephone visit;” and (3) “video telehealth visit.” Chi-square tests were used to assess associations across centers and different types of telehealth utilization.
Results
1,969 unique persons with MS (PwMS) were included in our analysis. 75.4% were female, mean age was 50 years and 79.4% had relapsing MS (RRMS). 1,604 (81.4%) of the 1,969 unique PwMS utilized at least one clinic visit, generating 1,805 total encounters. Of these, 814 (45.1%) utilized in-person, 508 (28.1.%) utilized telephone, and 483 (26.8%) utilized video telehealth visits. Utilization types varied significantly (p<0.01) across MS-CQI centers: (1) in-person (3.8%-52.9%); (2) telephone (0%-31.6%); and (3) video telehealth (9.5-43.4%). Urban MS-CQI centers utilized video telehealth more than rural (39.7% vs. 22.3%), and rural centers utilized telephone visits more often (34.2% vs. 10.8%). Academic MS centers utilized video telehealth visits more than non-academic MS centers (47.0% vs. 18.8%), and non-academic MS centers utilized telephone visits more frequently than academic MS centers (34.7% vs. 11.5%).
Conclusions
Telehealth utilization for MS care has increased dramatically since the onset of the COVID pandemic and is likely to remain a lasting part of MS care in the future. Our findings contribute to initial evidence that system-level (small area geographic) variation in telehealth utilization exists in MS care in the COVID era. This invites further study on how MS care systems can best utilize and standardize telehealth to optimize equity, access, and population health outcomes for PwMS.