Outcomes From a Regional Synchronous Tele-Allergy Service.

Abstract

Although the framework and potential benefits for using telemedicine have been described, allergy-specific outcomes are often limited or have a narrow focus. To determine the percentage of new and follow-up visits conducted via synchronous telemedicine requiring an in-person visit. A retrospective review evaluating synchronous tele-allergy appointments in a hospital-based allergy clinic was performed. A total of 360 unique patients participated in 423 synchronous tele-allergy visits from January 2016 to December 2017; 275 (65.0%) were new consultations, 54% were males, and 118 (28%) visits were for children. Allergic rhinitis (35%), asthma (24%), and food allergy (10%) represented the top 3 diagnoses. New and follow-up tele-allergy visits accounted for 13.1% (275 of 2097) and 10.4% (148 of 1426) of all outpatient visits during the study period, respectively. Sixty-five (23.4%) new patients and 14 (9.5%) follow-up patients were recommended for an in-person appointment (P < .001). Compared with follow-up tele-allergy visits, new visits were more likely to have medication prescribed (64.4% vs 49.0%; P < .002) and laboratory tests ordered (46.2% vs 7.4%; P < .001); there were no differences between new and follow-up tele-allergy visits for mean study observation period (P = .680), subsequent in-person visits conducted on the basis of provider recommendation (P = .120), or telephone consultations (P = .190). One hundred forty (33.1%) patients completed an anonymous satisfaction survey, with 98.8% of patients recommending telehealth and reporting high satisfaction. On the basis of 423 visits from 13 originating sites, patients saved an average of $485 in travel expenses, 438 driving miles, and 2.3 days of work or school per visit. Coupled with high patient satisfaction and significant time and cost savings, tele-allergy supported most of the new and follow-up visits without an in-person recommendation. Although not all tele-allergy efforts incorporate a synchronous modality with a dedicated patient presenter, allergists should continue to seek opportunities to incorporate synchronous tele-allergy with a trained patient presenter into their clinical practice.