Researchers at the UC San Diego School of Medicine found that offering a telemedicine clinic for high-risk patients resulted in fewer readmissions.
The results of the three-year study, published in the Sept. 23 online edition of JMIR Medical Informatics, showed that the overall 30-day readmission rate for patients seen in the virtual transition of care clinic was 14.9%. That’s compared to 20.1% for the benchmark group.
“Our clinic is a one-time, virtual visit with a patient immediately after their hospital stay to ensure we’re doing all we can to mitigate risk,” said Dr. Sarah Horman, lead author of the study and professor of medicine at UC San Diego School of Medicine.
Across the nation, hospital readmissions pose a significant burden on patients, health care providers and medical systems, with an estimated annual cost of $17 billion.
To address this challenge, according to a news release, a team of physicians and executive leadership at UC San Diego Health implemented the virtual clinic, to support management of specialty care for discharged patients.
Launched in 2021, the virtual transition of care clinic is supported by 12 hospitalists, two medical assistants, one pharmacist and an on-demand interpreter service.
During the study, a standardized hand-off was routed to the patient’s primary care provider and relevant specialists who summarized the reason for hospitalization, follow-up care and timing recommendations. For patients who experienced issues post-discharge, expedited calls were made from the virtual care team to the patient’s primary care provider to ensure the patient was seen in-person quicker.
“When telemedicine first began, there was concern it would further increase health disparities, especially in vulnerable patient groups. However, through our research, we have found the opposite as the virtual clinic reaches patients more effectively,” said Horman, hospitalist and affiliate faculty at the Joan and Irwin Jacobs Center for Health Innovation at UC San Diego Health.
She cited an example – patients who do not have access to transportation for in-person follow-up visits were more prone to skip them, “resulting in an increased risk of hospital readmission.”
In addition, if patients didn’t have access to video visits, telephone calls were arranged. In total, the no-show rate for these follow-ups was less than 5%, Horman said.
“Our goal is to hardwire this linkage in the care chain between the hospital team and primary care in order to help expedite support during that very sensitive, post-hospital period of time,” said Horman. “As a result, patient outcomes are improving while they recover at home and hospitals have capacity to take care of the next patient in need of critical care.”
The study involved more than 25,000 participants cared for at UC San Diego Health from Sept. 1, 2021 to Sept. 17, 2024. Of the participants, 2,314 were seen in the virtual clinic and 23,129 had standard follow-up care as the study’s benchmark group.
The typical time a patient is seen by their primary care physician after a hospital stay is two to four weeks. Through the clinic, patients who are considered moderate or high risk in terms of health outcomes are seen within a week after discharge.
The virtual transition of care clinic at UC San Diego Health is ongoing. Medical staffers at the clinic are currently seeing patients cared for at the Hillcrest and Jacobs medical centers, with plans to launch at the East Campus Medical Center soon.
