Abstracts

Rationale:
Neurology especially epilepsy is an underserved specialty. Telemedicine, as synchronous direct patient care model, is a well established, safe and viable option to provide care to patients while reducing cost of transportation and improving access to families living in rural areas. Neurology has been involved in providing telemedicine for several years. In this format, the provider is located at the distant site with a patient and facilitator located at the originating site. This model allows for a comprehensive general and neurological examination . With the COVID-19 pandemic a need arose to reduce exposure risk to patients by limiting in-person visits. This includes the traditional telemedicine model that requires patients to present at a clinic site. Therefore, telemedicine was rapidly transitioned to a model where the provider can communicate with the patient in their home, eliminating the need for a facilitator to be on site and reducing risk for exposure to families and patients. However, this model presents limitations to the examination secondary to the lack of facilitator at the originating site. Data relating to this model is limited regarding patient/family and provider satisfaction as well as risks. 
Method:
This is a quality improvement mixed method utilizing pre-post measures evaluation project, reviewed by institutional IRB and deemed to be non-human subjects research. . Retrospective National Research Council (NRC) data from the last 3 months will be compared to current NRC data for the duration of in-home telemedicine utilization, up to 3 months’ time. These data are utilized to determine patient/parent satisfaction following ambulatory care visits. If in-home telemedicine utilization ends prior to 3 months duration data collection will end upon return of all ambulatory patients to the former clinic model. Providers participating in in-home telemedicine visits will be invited to complete a one-time survey 3 months post implementation of in-home telemedicine as part of this research protocol, or the completion of in-home telemedicine visits, whichever comes first, to assess their satisfaction on this appointment type. This survey will be completed via REDCap and will not collect any identifiable information. Queries of the electronic medical record will be completed to assess number of patients who had an in person visit (clinic, hospital admission, or emergency department) within 7 days of their in-home telemedicine visit. Assessing rate of in-person visits following an in-home telemedicine visit will help identify events of escalation of care
Results:
Results will be analyzed utilizing descriptive statistics. NRC data are analyzed with descriptive statistics as well as chi-square test if test requirements are met.
Conclusion:
This project will demonstrate both family and provider satisfaction with the in-home telemedicine model in a subset of patients. In addition, risks associated with this model will be identified to add to the literature regarding safety of this model. This project provides significant data to support use and identify the limits of telemedicine.
Funding:
:No outside funding has been received to support this abstract. This work was supported by department funding.