Assessing the Impact of a Rapidly Scaled Virtual Urgent Care in New York City During the COVID-19 Pandemic

Abstract

Background: The coronavirus disease (COVID)-19 pandemic quickly challenged New York City health care systems. Telemedicine has been suggested to manage acute complaints and divert patients from in-person care.

Objectives: The objective of this study was to describe and assess the impact of a rapidly scaled virtual urgent care platform during the COVID-19 pandemic.

Methods: This was a retrospective cohort study of all patients who presented to a virtual urgent care platform over 1 month during the COVID-19 pandemic surge. We described scaling our telemedicine urgent care capacity, described patient clinical characteristics, assessed for emergency department (ED) referrals, and analyzed postvisit surveys.

Results: During the study period, a total of 17,730 patients were seen via virtual urgent care; 454 (2.56%) were referred to an ED. The most frequent diagnoses were COVID-19 related or upper respiratory symptoms. Geospatial analysis indicated a wide catchment area. There were 251 providers onboarded to the platform; at peak, 62 providers supplied 364 h of coverage in 1 day. The average patient satisfaction score was 4.4/5. There were 2668 patients (15.05%) who responded to the postvisit survey; 1236 (49.35%) would have sought care in an ED (11.86%) or in-person urgent care (37.49%).

Conclusions: A virtual urgent care platform was scaled to manage a volume of more than 800 patients a day across a large catchment area during the pandemic surge. About half of the patients would otherwise have presented to an ED or urgent care in person. Virtual urgent care is an option for appropriate patients while minimizing in-person visits during the COVID-19 pandemic.

Keywords: COVID-19; New York City; telehealth; telemedicine; urgent care.

Figure 1

Daily patient volumes in virtual urgent care during the study period. The twelve days preceding the study period are also included for comparison.

Figure 2

Geocoded map of virtual urgent care patient volume by zip code in the (A) larger tristate area and (B) in the New York City area.

Figure 3

Box plot of median wait time and median visit duration, with interquartile ranges, for virtual urgent care visits during the one-month study period.

Figure 4

Survey responses to “Where would you have sought care today had virtual urgent care not been available?”.

Figure 5

Patient survey response scores, on a 1 to 5 scale, for satisfaction (A), likelihood to recommend (B), likelihood to use again (C), and overall needs met rating (D).