Outcomes from a regional synchronous tele-allergy service

Publication date: Available online 29 October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Kirk H. Waibel, Richard A. Bickel, Tyson Brown

Abstract

Background

While the framework and potential benefits for using telemedicine have been described, allergy-specific outcomes are often limited or have a narrow focus.

Objective

To determine the percentage of new and follow-up visits conducted via synchronous telemedicine requiring an in-person visit.

Methods

A retrospective review evaluating synchronous tele-allergy appointments in a hospital-based allergy clinic was performed.

Results

A total of 360 unique patients participated in 423 synchronous tele-allergy visits from January 2016 through December 2017; 275 (65.0%) were new consultations, 54% were male, and 118 (28%) visits were for children. Allergic rhinitis (35%), asthma (24%), and food allergy (10%) represented the top three diagnoses. New and follow-up tele-allergy visits accounted for 13.1% (275/2,097) and 10.4% (148/1,426) of all outpatient visits during the study period, respectively. Sixty-five (23.4%) new patients and 14 (9.5%) follow-up patients were recommended for an in-person appointment. (P < .001). Compared to follow-up tele-allergy visits, new visits were more likely to have medication prescribed (64.4% vs 49.0%, P < .002) and laboratory tests ordered (46.2% vs 7.4%, P <.001); there were no differences between new and follow up tele-allergy visits for mean study observation period (P = 0.68), subsequent in-person visits conducted based on provider recommendation (P = 0.12), or telephone consultations (P = 0.19). One-hundred forty (33.1%) patients completed an anonymous satisfaction survey with 98.8% of patients both recommending telehealth and reporting high satisfaction. Based on 423 visits from 13 originating sites, patients saved an average of USD $485 in travel expenses, 438 driving miles, and 2.3 days of work or school per visit.

Conclusion

Coupled with high patient satisfaction and significant time and cost savings, tele-allergy supported the majority of new and follow up visits without an in-person recommendation. While not all tele-allergy efforts incorporate a synchronous modality with a dedicated patient presenter, allergists should continue to seek opportunities to incorporate synchronous tele-allergy with a trained patient presenter into their clinical practice.