|
?:abstract
|
-
Study Objectives: Patient navigation, first heralded by Dr Freeman and colleagues for low-income breast cancer patients more than 25 years ago, is now an essential part of care coordination within our complex medical system, particularly for vulnerable populations With the continued growth in health care spending (estimated at $3 6 trillion in 2018), the number of uninsured as well as patients’ out-of-pocket expenses continue to increase Navigator Programs have demonstrated success facilitating follow-up care for genetic counseling, geriatric populations, emergency department patients, and primary care Further investigation into the impact and cost-effectiveness of patient navigation has been suggested Direct-to-Consumer telemedicine services continue to grow, including exponential increase during the Covid-19 pandemic There may be a role for patient navigation in facilitating ongoing/continuity of care following virtual urgent care encounters, especially given that the use of this type of service may be a marker for at risk patients who are using episodic telehealth encounters as their only access to care Methods: In July of 2016, the Weill Cornell Medicine Department of Emergency Medicine, in conjunction with NewYork-Presbyterian, implemented a virtual urgent care service staffed by faculty who are part of an academic EM practice ED physicians could refer patients to a ED Patient Navigator (PN) program using a computerized provider order entry when patients were seen by telemedicine or when they were seen in the physical ED PN referrals were made for both primary and specialty care at ED physician discretion The PN contacted the patient asynchronously by telephone, scheduling the patient with the appropriate outpatient service appointment(s), facilitating patient compliance via follow up calls and documenting the outcomes of each referral We compare PN quality assurance data for both telemedicine patients and for ED patients navigation success rate for ED and Virtual Urgent Care patients Results: Successful patient navigation was defined as the percentage of telemedicine patients referred to the program who attended their referred in person appointment From March 1, 2019 until June 30, 2019, 234 patients were referred to the PN, 23 (10%) had appointments successfully made, and 10 (4%) completed their appointments During the same time period 3,721 patients were referred to patient navigation in the physical ED, 1,663 (44%) had an appointment successfully made and 1,096 (29%) completed their appointment All differences are statistically significant at the p<0 01 level Conclusion: As we increase virtual care, there is an opportunity to further explore the role of PNs Navigation of virtual urgent care service patients had a lower rate of success in attempting to make appointments, and scheduled appointment compliance compared with emergency department patients referred to the same group of PNs by physicians in the same faculty practice The extent to which this discrepancy was due to insurance status, patient investment in the PN process, or other differences between groups is not known
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}