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Accepted manuscript

Feasibility of and Experience with Free State Funded Telehealth Based Patient Self-referral for COVID-19 Monoclonal Antibody Therapy

Published online by Cambridge University Press:  13 September 2023

Ishaan Gupta*
Affiliation:
Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Sophia Purekal
Affiliation:
Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Yahya Shaikh
Affiliation:
MITRE Corporation, Baltimore, Maryland
Henry J. Michtalik
Affiliation:
Department of Medicine, Johns Hopkins University, Baltimore, Maryland Armstrong Institute for Patient Safety, Johns Hopkins University, Baltimore, Maryland
Shaker M. Eid
Affiliation:
Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Laura Wortman
Affiliation:
Healthcare Transformation and Strategic Planning, Johns Hopkins Medicine, Baltimore, Maryland
MaryJane E. Vaeth
Affiliation:
Baltimore Convention Center Field Hospital, Baltimore, Maryland
Charles F S Locke
Affiliation:
Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Elizabeth Hoemeke
Affiliation:
Baltimore Convention Center Field Hospital, Baltimore, Maryland
Raena Hariharan
Affiliation:
Department of General Internal Medicine, Johns Hopkins Community Physicians, Johns Hopkins Health System, Baltimore, Maryland
Charles D. Callahan
Affiliation:
Department of Population Health, University of Maryland Medical Center, Baltimore, Maryland
James R. Ficke
Affiliation:
Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
Isabel Pimenta
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Paul G. Auwaerter
Affiliation:
Sherilyn and Ken Fisher Center for Environmental Infectious Diseases, JHUSOM, Baltimore, Maryland
Melinda E. Kantsiper
Affiliation:
Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Zishan K. Siddiqui
Affiliation:
Department of Medicine, Johns Hopkins University, Baltimore, Maryland
*
*Corresponding author: Email: igupta4@jhmi.edu

Abstract

Background:

Monoclonal antibody (mAb) treatment for COVID-19 has been underutilized due to logistical challenges, lack of access and variable treatment awareness among patients and healthcare professionals. The use of telehealth during the pandemic provides an opportunity to increase access to COVID-19 care.

Methods:

This is a single-center descriptive study of telehealth-based patient self-referral for mAb therapy between March 1, 2021, to October 31, 2021 at Baltimore Convention Center Field Hospital (BCCFH).

Results:

Among the 1001 self-referral patients, the mean age was 47, and most were female (57%) white (66%), and had a primary care provider (62%). During the study period, self-referrals increased from 14 per month in March to 427 in October resulting in a 30-fold increase. About 57% of self-referred patients received a telehealth visit, and of those 82% of patients received mAb infusion therapy. The median time from self-referral to onsite infusion was 2 days (1-3 IQR).

Discussion:

Our study shows the integration of telehealth with a self-referral process improved access to mAb infusion. A high proportion of self-referrals were appropriate and led to timely treatment. This approach helped those without traditional avenues for care and avoided potential delay for patients seeking referral from their PCPs.

Type
Original Research
Copyright
© 2023 Society for Disaster Medicine and Public Health, Inc.

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Footnotes

These authors have contributed equally to the manuscript as co-first authors

CONQUER COVID Consortium members include Lee Ann Wagner MD, Jeffrey Fink