Telemedicine in Otolaryngology in the COVID-19 Era: Initial Lessons Learned

Objectives/Hypothesis: The COVID-19 pandemic has led to unprecedented global changes in the delivery of healthcare over a short period of time. With the implementation of shelter-in-place orders, otolaryngology clinic visits at our institution were transitioned to telemedicine. This change enabled the rapid characterization of the patients who accepted and declined telemedicine. Study Design: Cross-sectional analysis. Methods: A review was conducted of 525 otolaryngology patients at a tertiary-care referral center with scheduled visits requiring rescheduling to a future date or a telemedicine visit. Visit, demographic information, and reason for deferring telemedicine were collected for analysis. Results: Seventy-two percent of patients declined a telemedicine visit, with the most common reason being the lack of a physical exam (97%). There was an even distribution of demographics between those who accepted and declined visits. There was an association between declining telemedicine with older age (P =.0004) and otology visits (P =.0003), whereas facial plastics patients were more likely to accept (P <.0001). Patients scheduled earlier during the pandemic were more likely to accept a visit with a median of 28 days from onset of shelter-in-place orders versus 35 for those who declined (P <.0001). Conclusions: We describe our initial experience with a transition to telemedicine, where the majority of patients would decline a virtual visit due to the lack of a physical exam. Although the future remains uncertain, telemedicine will continue to play a vital role in healthcare delivery. We believe that understanding our patient base gives critical insights that will help guide and improve virtual care to meet patients' needs. Level of Evidence: 4 Laryngoscope, 130:2568–2573, 2020.