COVID-19 necessitated widescale adoption of telemedicine (TM) and restriction of in-person care. The impacts on allergy/immunology (A/I) care delivery are still being studied.
To describe the outcomes of rapid transition to TM-based care (video visit followed by in-person visits dedicated to diagnostic and therapeutic procedures when needed) at an academic A/I practice during COVID-19.
Demographic data were compared for patients originally scheduled for in-person visits between 3/10/20-4/30/20 who completed a video visit instead between 3/10/20-6/30/20, and those who did not. Appointment completion, diagnoses, and drug allergy (DA) and skin testing (ST) completion were compared for visits between 3/10/20-6/30/20 and one year prior (3/10/19-6/30/19).
Sixty-nine percent (265/382) of patients originally scheduled between 3/10/20-4/30/20 were able to complete video visits. Patients who completed video visits were more likely to be White (52% vs 33%; p<0.001), English-speaking (96% vs 89%; p=0.01), and privately insured (70% vs 54%; p=0.004). With TM-based care compared to in-person care, there were significant decreases in environmental and food ST completion rates (91% and 92% in 2019 vs 60% and 64% in 2020, respectively, p<0.001). DA testing completed after internal referral remained low but comparable (51% in 2019 vs 52% in 2020). Transitioning non-procedural visits to video allowed allergen immunotherapy and biologic injection visits to resume at a volume similar to pre-COVID. No COVID-19 infections resulted from in-clinic exposure.
While transitioning to TM-based care allowed continued A/I care delivery, strategies are needed to achieve higher testing completion rates and ensure video visits do not exacerbate existing disparities.

Copyright © 2021. Published by Elsevier Inc.

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