Delivering urgent care services for adult patients by way of video visits at Helsinki University Hospital joint emergency care departments - retrospective observational study

Abstract

Abstract Objective We aimed to study how video visits could replace in-person visits in emergency care clinics. The objective of this study was to characterise those patient groups that are suitable for receiving care via video visits. We describe our experiences with the number of visits, patient groups and how often the video visits replaced in-person visits in ED on contact day and follow-up visits in ED within 21 days after the index day. The patients in our setting were over 16 years of age. After the initial video visit, we assessed the subsequent medical follow-up visits (at ED), X-rays and laboratory tests performed as well as the antibiotics prescribed. We also present patient self-reported data on patient satisfaction and their video visit experiences. Design: A retrospective observational study Setting: Emergency departments (EDs) in the Uusimaa region of Finland. Video visits in the ED are a pilot project implemented by Helsinki University Hospital that has been financed by the development project fund that promotes the hospital’s strategic goals. Participants : A total of 601 patients registered for video visits were included in the analysis in the period 4/3/2022–29/5/2022. Interventions: The seven physicians who were hired exclusively for the project used a digital EPR platform to connect with patients through synchronous video communication. Main outcome measures: EPR data from the video visits, including patient demographics, visit characteristics and patient satisfaction. Results There were 601 patients cared for through telemedicine during the observation period. Those patients receiving care by video visits had a mean age of 38 (standard deviation 15.5). A wide range of diagnoses was given to patients during the video. Twenty-one days after the initial video visit, 83% (501) of the patients had not been seen by a medical provider in the ED. Twenty-one-day returns requiring ED admission were 9.8% (n = 59) with the same reason for the encounter as in the video visit. The patient satisfaction scores with video visits were high (NPS 80 avg. 9.3) Conclusions Telemedicine adoption in ED settings requires more evidence of telehealth benefits. Providing care via video visits for ED patients without compromising patient satisfaction can be effective if the admission is based on a carefully assessed need for ED care and patient safety is ensured during all the stages of the patients’ pathway.