Abstract Details

Title The Impact of the Coronavirus Pandemic in Neurology Residency Clinic: A Single Program Experience

Topic Research Methodology, Education, and History

Presentation(s) Research Methodology and Education Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 039

Background In continuity clinic residents learn to manage their own patient population and become proficient in the business and logistics aspects of outpatient medicine. Many institutions including ours shut down outpatient clinics at the onset of the COVID-19 pandemic. In March 2020, the Accreditation Council for Graduate Medical Education dropped restrictions on resident clinician involvement in telemedicine. From March 23rd to June 30th 2020 (intra-pandemic), our neurology resident clinic operated primarily via telemedicine.

Objective

To examine the effects of the coronavirus (COVID-19) pandemic on neurology resident clinic experience and productivity.

Design/Methods We compared resident clinic operations intra-pandemic to pre-pandemic (July 2019-February 2020) baselines for PGY2 to PGY4 neurology residents. We measured patient interactions by clinic fill rate and utilization. Clinic workflow was measured with no-shows/unable to contact, conversion of video visits to telephonic, and scheduling of return appointments. Financial productivity was measured by average billing level of service and revenue.

Results We analyzed a total of 390 intra-pandemic visits. Fill rate and utilization decreased 9.5% and 3.8% intra-pandemic. Overall no-show rate was not substantially different pre- and intra-pandemic. Fifteen percent of televideo visits were converted to telephonic due to technical challenges. Fifty eight percent of return visits were scheduled by the time of the analysis, and early returns (0-2 months) comprised just 9.56%. The level of service and reimbursement decreased due to the constraints of telemedicine. Twenty three percent of visits were not billed. Most of these were telephonic visits.

Conclusions The changes in our resident clinic largely reflect the changes in productivity across all healthcare systems due to the pandemic. Decreased fill rate, decreased utilization, and high number of telephonic visits translate to decreased overall resident clinical exposure. The long-term effects of these changes in resident training and patient care remain to be seen.

Authors/Disclosures
Micaela R. Owens, DO (Marshall University) PRESENTER	Dr. Owens has nothing to disclose.
Kenny A. Schwartz, MD (Geisinger Health System)	Dr. Schwartz has nothing to disclose.
Edward Stefanowicz (Geisinger)	No disclosure on file
J. David Avila, MD (Geisinger Medical Center)	Dr. Avila has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Avila has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alnylam Pharmaceuticals. Dr. Avila has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for argenx. Dr. Avila has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion Pharmaceuticals. Dr. Avila has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Avila has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZeneca. Dr. Avila has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda.