Authors :
Presenting Author: Ahmad Sawalha, MD – Philadelphia College of Osteopathic Medicine.
David Burkholder, MD – Mayo Clinic
Rationale:
By March 2020, COVID-19 had been declared a global pandemic and it was announced to be a national emergency. Due to that, many states announced executive orders to delay nonurgent procedures including admissions to epilepsy monitoring unit (EMU). In this paper, we intended to study the operational changes done at the mayo clinic in the first year of the pandemic and the potential barriers to have epilepsy surgery and if the evolving mechanisms to deliver care helped with reducing the delay in getting into surgery.
Methods:
We obtained the healthcare records for our patients from the epilepsy conference sheets and the medical record system including any delays or cancellation of epilepsy surgeries. We compared the timeline for the patients who were referred epilepsy surgery during the pandemic and patients who were referred to epilepsy surgery in the pre-pandemic year. We investigated each case by reviewing their chart. We analyzed the time to certain instrumental points in evaluation that all eligible patients would go through (first neurology visit to epilepsy monitoring unit evaluation; epilepsy monitoring unit evaluation to conference presentation; conference presentation to first neurosurgical consultation; neurosurgical consultation to procedure) as well as the causes behind the delay or cancellation of epilepsy surgery.
Results: The total number of patients who underwent epilepsy surgery in pre-pandemic year was 101 patients compared to 98 patients in the pandemic year. The period in months between surgical epilepsy conference presentation and getting the surgery was similar between both groups (7 months and 6.4 months respectively). After excluding patients who had DBS in the pre-pandemic year (11 patients) who had significant delays due to insurance approval, the period decreased to 6.1 months. Only two cases were cancelled due to COVID related reason, and six cases were significantly delayed (more than six months). After EMU evaluation, 88 patients during the pandemic year had a documented follow up with neurosurgery and only 25 out of them had it through telemedicine.
Conclusions: This study revealed that despite all of the operational changes due to the COVID pandemic and barriers to see healthcare providers, our patients in Mayo Clinic were able to get to epilepsy surgery without significant delays.
Funding: Not applicable.