In-person follow-up visit attendance after telemedicine visits

BackgroundAlthough Coronavirus disease 2019 rapidly increased the use of telemedicine for pediatric primary care, vaccinations, screening tests, lab draws, and other procedures still require followup in-person visits. We investigated in-person follow-up rates after telemedicine visits at our primary care clinic, and what patient or visit characteristics were associated with non-completion of in-person follow-up.MethodsA retrospective cohort study was conducted of telemedicine visits completed between April and May 2020. A manual chart review was performed to determine which encounters required a follow-up in-person visit; and was tracked through August 2020. Bivariate comparisons were performed according to completion of in-person follow-up and multivariable analysis of followup visit attendance was performed using Cox proportional hazards regression.ResultsOf 500 eligible encounters, 16% did not attend at least one in-person follow-up. The median time for follow-up was 2 days (IQR: 1, 6). Patients older than 1 year of age (32%, p= <0.001) and with Medicaid insurance (83%, p=0.019) were more likely to not complete a follow-up visit. The likelihood of completion was higher for Hispanic as compared to non-Hispanic Black patients (HR: 1.65; 95% CI: 1.28, 2.12; p<0.001) and patients requiring routine screening (HR: 1.40; 95% CI: 1.04, 1.89; p=0.028). document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only oneConclusionNot all required in-person follow-ups were completed after telemedicine visits, which could have negative impacts on children's health. Improving the transition between telemedicine and in- person follow-up of primary care can help ensure the quality of care provided in a telemedicine- first model.