O1127: Direct to Consumer Telehealth Video Visit: ensuring Clinical Quality in an on Demand Virtual Urgent Care

Background: As a leader in healthcare for pediatric patients, we began an incredible journey toward offering another service line to patients through Telehealth January 2020 called Virtual Urgent Care. The Division of Emergency Medicine was approached by the Center for Telehealth at our hospital to understand if we would be interested in partnering with them on this journey in the Fall of 2018. We agreed to begin the planning process. This session will provide an opportunity to learn about how we developed our quality telehealth service and the evaluation of the program as it has developed over time, as well as what the future looks like for this new service line. We will share the knowledge gained and the experience related to our journey and what we will continue to work on moving forward in the future.

Methods: The Medical Center focused on creating a quality pediatric service for on demand virtual urgent. These characteristics included appropriate antibiotic prescribing, communication with the patient's primary care physician, patient family experience score, weekly chart review of the providers outside of the hospital they provide the coverage overnight. There also has been additional provider training, a set list of conditions for telehealth evaluation and plan for follow up as needed with any test results such as COVID. The service is staffed by dedicated Advance Practice Providers (APP) who also work in the hospital's physical urgent care with at least two years of physical Urgent Care and Emergency Department. Providers can immediately refer patients for in person visits when necessary. Data was collected from both the telehealth platform and the hospital's electronic medical record.

Results: Our Virtual Urgent Care has evaluated more than 6,000 patients since launch on January 19, 2020. Several measures are in place to ensure that all of these patients receive a quality pediatric experience. All have completed in person and online trainings for both telehealth workflow and clinical remote exams. To date, antibiotic prescribing is less than 10%, which uses orders/labs to confirm the need; and communication to primary care physicians is monitored and expected to be sent 86% for all visits. The hospital also reports on the number of patients who adhered to the Virtual Urgent Care Provider recommendation that the visit was resolved via telehealth or was referred for and in person visit. All of these scores point to high patient satisfaction, current to date is 87.8% give us a 9/10.

Conclusion: To provide a high-quality Telehealth service, it is necessary to have quality measures in place to continually evaluate the program and work towards continuous improvement. The future for Telehealth is bright as long as a high-quality service is offered and monitored. We hope to share our knowledge and experience.