Abstract Details

MSCQI is the first multi-center improvement research collaborative for MS care.  it is a 3-year study to evaluate system-level performance variation and improve MS population health outcomes.  Prior to COVID, telehealth was not utilized in participating MSCQI centers, but after COVID onset, centers began utilizing telehealth in various ways.  Telehealth utilization data was collected to study system level variation.

Describe system-level variation in MS clinical care utilization by type of visit for the last six months of the MSCQI study during the COVID pandemic.

1,969 unique patients were included in analysis.  75.4% were female with mean age of 50 and 79.4% had relapsing MS (RRMS).  1,604 (81.4%) of these patients utilized at least one clinic visit, generating 1,805 encounters.  Of these, 814 (45.1%) utilized in-person, 508 (28.1.%) utilized telephone, and 483 (26.8%) utilized video telehealth.  Utilization varied significantly (p<0.01) across MSCQI centers: in-person (3.8%-52.9%); telephone (0%-31.6%); and video telehealth (9.5-43.4%).  Urban centers utilized video telehealth more than rural (39.7% vs. 22.3%), and rural centers utilized telephone visits more (34.2% vs. 10.8%).  Academic centers utilized video telehealth more than non-academic centers (47.0% vs. 18.8%), and non-academic centers utilized telephone visits more than academic centers (34.7% vs. 11.5%).

Telehealth utilization for MS care has increased dramatically since COVID pandemic and will remain a lasting part of MS care in the future.  Findings suggest that system-level variation in telehealth utilization exists in MS care in the COVID era.  This invites further study on how MS care systems can best utilize and standardize telehealth to optimize equity, access, and population health outcomes.