Association between the Number of Consecutively Scheduled Telehealth Visits and Video Usage.

Background: Schedule design may contribute to successful completion of synchronous telehealth visits by video (versus audio-only). Clustering telehealth visits on schedules may minimize workflow inefficiencies. Methods: We analyzed data from 21 primary care sites in an urban public health care system from March 1 to September 30, 2022. We used linear regression to test for associations between the number of consecutive telehealth visits scheduled per clinicians' half-day sessions (1 to 9+) and the proportion of telehealth visits scheduled and, separately, completed as video (versus audio-only). Results: For each additional consecutive telehealth visit scheduled, there was a 6.85% [95% confidence interval 4.80 - 8.90%] increase in the absolute percentage of visits scheduled as video visits. For each additional consecutive telehealth visit scheduled, there was a 2.88% [0.59 - 5.18%] increase in the absolute percentage of visits completed as video visits. Conclusions: Clustered telehealth visits are positively associated with scheduling and completion of telehealth visits by video.

Effect of a Telehealth Navigator Program on Video Visit Scheduling and Completion in Primary Care.

INTRODUCTION: Patients and clinicians face challenges in participating in video telehealth visits. Patient navigation has been effective in other settings in enhancing patients' engagement with clinical programs. Our objective was to assess whether implementing a telehealth navigator program to support patients and clinicians affected video visit scheduling, video usage, and non-attendance. METHODS: This was a quasi-experimental quality improvement project using difference-in-differences. We included data from 17 adult primary care sites at a large, urban public healthcare system from October 1, 2021 to October 31, 2022. Six sites received telehealth navigators and 11 sites were used as comparators. Navigators contacted patients (by phone) with upcoming video visits to assess and address potential barriers to successful video visit completion. They also provided on-site support to patients and clinicians regarding telehealth visits and usage of an electronic patient portal. The primary outcomes were difference-in-differences for the proportion of telehealth visits scheduled and, separately, completed as video visits and non-attendance for visits scheduled as video visits. RESULTS: There were 65 488 and 71 504 scheduled telehealth appointments at intervention and non-intervention sites, respectively. The adjusted difference-in-differences for the proportion of telehealth visits scheduled as video was -9.1% [95% confidence interval -26.1%, 8.0%], the proportion of telehealth visits completed as video visits 1.3% [-4.9%, 7.4%], and non-attendance for visits scheduled as video visits -3.7% [-6.0%, -1.4%]. CONCLUSIONS: Sites with telehealth navigators had comparatively lower video visit non-attendance but did not have comparatively different video visit scheduling or completion rates. Despite this, navigators' on-the-ground presence can help identify opportunities for improvements in care design.