Deployment of an Interventional Radiology Telemedicine Program During the COVID-19 Pandemic: Initial Experience With 10,056 Visits

Abstract

Objective: To evaluate the clinical, operational, and financial effects of using telemedicine services in an academic interventional radiology setting during the coronavirus disease 2019 pandemic and to identify potential barriers to equitable telemedicine access for patients.

Methods: Evaluation and management (E&M) data over a 104-week period from September 2019 to August 2021 were reviewed. Data related to the visits were recorded including visit type, billing provider, patient demographic information, Current Procedural Terminology code charged, and reimbursement received. The ZIP code pertaining to the patient's primary residence was matched with median household income from the US Census Bureau.

Results: In all, 14,754 E&M encounters were performed over the study period, of which 10,056 were conducted using telemedicine. Twenty-two percent of visits were performed with interactive video; the remainder were performed using audio only. Female patients were more likely than male patients to use interactive video visits for telemedicine encounters (23.7% versus 20.4%, P < .001). Patients availing of video visits (mean age, 58.1 years, SD = 14.0) were also significantly younger than those patients who used audio-only (telephone) encounters (mean age, 62.5 years, SD = 13.3). Patients with private insurance and those living in neighborhoods with higher median household income were more likely to avail of interactive video visits (P < .001). Professional E&M monthly revenue was between 23.3% and 53.2% of peak prepandemic levels (mean 37.7%).

Conclusion: Telemedicine services allowed for rapid restoration of E&M encounter volumes over the study period. Further work is required to determine the potential implementation barriers to increasing the use of video visits.

Keywords: Evaluation and management; interventional radiology; telemedicine.

Fig. 1

Relative distribution of all telemedicine encounters based on patient’s home ZIP code (April 2020 to August 2021). A total of nine visits were performed for residents of US overseas territories (not shown).

Fig. 2

Graph outlining distribution of telephone encounters, in-person consultations, and video consultations over the study period. E&M = evaluation and management.

Fig. 3

Comparison of evaluation and management (E&M) revenue with number of clinic encounters over a 21-month period, during which both clinical and revenue data were available (September 2019 to May 2021). APP = advanced practice providers.

Fig. 4

The mean and median annual household income (as estimated using US Census Bureau Data) for all telemedicine encounters were $73,883 and $67,470, respectively. Encounters in which estimated median annual household income was available were divided into quartiles: quartile 1 = $51,309, quartile 2 = $67,470, and quartile 3 = $92,327.