Telemedicine Uptake in a Geriatric Assessment Center During the COVID Crisis

The Yale New Haven Hospital Adler Geriatric Assessment Center is an outpatient consultative service that provides comprehensive assessment of older adults. As elsewhere, at Adler the COVID crisis necessitated a rapid shift in mode of care following a total cessation of in-person visits from late March 2020 to the end of May 2020. While our patients initially preferred telephone visits, video visits as a proportion of total scheduled increased from an average of 6% in the last full week of March to 24% in the last week in May possibly indicating increasing familiarity and comfort with the technology during that time. In addition, while video appointments as a proportion of total scheduled dropped rapidly in June 2020 as face-to-face appointments were reintroduced, we found a steady increase in the proportion of video visits from 3% in the first week of July 2020 to 7% in the second week of February 2021. To test for significance, we ran logistic regression models modelling the dichotomous video-appointment variable as the outcome and week and day of week as continuous variables. We found there was a significant increase in the proportion of appointments delivered over video both during the time when no face-to-face video appointments were allowed (OR=1.21, CI=1.13,1.30) and later in the pandemic (OR=1.04, CI=1.02,1.06). Durbin-Watson statistics were run to ensure that autocorrelation could be ignored. Sensitivity analyses limiting the sample to those with non-cancelled appointments gave similar results. Future analyses will examine patient clinical and demographic characteristics that might influence these trends.