November 9, 2022
An Uncharted Frontier: Inpatient Telemedicine Infectious Diseases ConsultationsBy Manie Beheshti, MD
According to a 2020 study, nearly 80 percent of U.S. counties do not have an ID physician. During the COVID-19 pandemic, the Department of Health and Human Services reported on the accelerated access to care through telehealth. This raises the question of the potential impact of telemedicine ID consultative services (Tele-ID) on inpatient care.
The first of its kind, a recent publication in Open Forum Infectious Diseases compared patient outcomes between in-person and Tele-ID. On June 30, 2018, when the lone in-person ID consultant at three outlying hospitals of the University of Pittsburgh system departed, a Tele-ID system was established. This consisted of a rotating full-time ID physician providing virtual consultations for the three hospitals with the aid of a registered nurse at each site. The researchers compared the patient outcome data for the six months preceding June 30 (in-person ID) to the six subsequent months (Tele-ID). A significant increase in encounters was noted in the Tele-ID group (391) compared to the in-person ID group (251, P = .018). Bacteremia was the most common ID diagnosis in both groups, but the Tele-ID encounters included a wider arrange of diagnoses. The patient outcomes were similar with regard to length of stay, transfers, readmissions, and mortality.
Though this is a limited study with regard to sample size and temporal bias, it highlights an exciting moment in ID. As the authors conclude, Tele-ID is an enticing alternative, especially in areas without access to the many benefits of ID consultative services. Hopefully, this publication will spur further research and continue to shed light on this yet uncharted frontier.
