A Stepwise Transition to Telemedicine in Response to COVID-19

Abstract

Introduction: With the emergence of COVID-19, many primary care offices closed their physical space to limit exposure. Despite decades of telemedicine in clinical practice, it is rare to find it used in small-metro and academic settings. Following the decision to limit face-to-face care, we tracked our practice's transition to telemedicine. Methods: This was a prospective quality improvement project following Plan-Do-Study-Act (PDSA) cycles to optimize the use of telemedicine (both telephone and video in this practice) encounters. Central to the PDSA cycles was the use of a post-encounter questionnaire to track patient, appointment, and physician factors. Throughout the cycles, inferential statistics were used to inform process improvement. Results: In Cycle 2, a logistic regression model showed length of encounter, need for physical examination, and physician satisfaction correctly predicted a physician's preferred medium (x 2(3) = 40.56, P