Poster: The ID Physician is Out: Are Remote ID E-consults an Effective Substitute? - Infectious Disease Connect Poster: The ID Physician is Out: Are Remote ID E-consults an Effective Substitute? - Infectious Disease Connect

Academic Literature

Poster: The ID Physician is Out: Are Remote ID E-consults an Effective Substitute?

This poster highlighting remote tele-ID consults was originally presented at IDWeek 2021, held virtually Sept. 29 – Oct. 3, 2021

Sui Kwong Li, M.D.1,2; Carolyn Fernandes. M.D.1,2; Sowmya Nanjappa, M.D.1,2; Sarah Burgdorf, M.D.1,2;
Vidya Jagadeesan, M.D.1,2; Bettina Knoll, M.D.1,2, Shanza Khan, M.D.1,2, Nupur Gupta, DO MPH1,2; John W. Mellors. M.D.1,2; Rima Abdel-Massih, M.D.1,2

1. Division of Infectious Diseases, UPMC 2. Infectious Disease Connect

Conclusions

  • Mortality rates following e-consults appear to be comparable to those previously reported for in-person infectious disease (ID) care1,2.
  • In the absence of in-person ID physicians, ID e-consults may be a reasonable substitute.
  • Further study is required to compare performance of ID e-consults to in-person ID consults.

Objective

  • Determine whether ID e-consults can be an effective substitute for in-person care
  • Establish baseline data for outcomes related to ID e-consults

Background

Methods

Key Findings

Results

Table 1. Clinical Characteristics (n=121)
Age, mean (SD), y 61.2 (16.7)
Gender, No.%
Female50 (41.3)
Male71 (58.7)
Race, No. (%)
White115 (95.0)
Other6 (5.0)
BMI, mean (SD)31.5 (8.6)
Immunocompromised State, No. (%) 21 (17.4)
Immunosuppressive Agents*5 (4.1)
Solid Tumor11 (9.1)
Hematologic Malignancy5 (4.1)
Charlson Comorbidity Index Sore, mean (SD) 4.8 (3.0)
Hospitalization during previous 6 months, No. (%)
Yes57 (47.1)
No64 (52.9)
ICU status at the time of e-consult, No. (%)
Yes13 (10.7)
No108 (89.3)
*Apremilast, Dasatinib, Etanercept, Infliximab, Rituximab, or Prednisone >10 mg/day

Table 2. Outcomes
Length of stay, mean (SD), d
Total11 (9)
Post initial ID e-consult7 (8)
Disposition, No. (%)
Home59 (48.7)
Post-acute rehabilitation facility45 (37.2)
Left against medical advice7 (5.8)
Hospice3 (2.5)
Hospital transfer3 (2.5)
Index stay mortality4 (3.3)
Death within 30 d of ID e-consult, No. (%)5 (4.1)
Readmission within 30 d post-discharge, No. (%)31 (25.6)
Readmission within 30 d related to initial infection, No. 17 (14.0)

References

1Tande AJ, Berbari EF, Ramar P. et al. Association of a Remotely Offered Infectious Diseases eConsult Service with Improved Clinical Outcomes. Open Forum Infectious Diseases. 2020;7(1), ofaa003 https://doi.org/10.1093/ofid/ofaa003

2Schmitt S, McQuillen DP, Nahass R et al. Infectious Diseases Specialty Intervention is Associated with Decreased Mortality and Lower Healthcare Costs. Clin Infect Dis. 2014;58(1):22-8.


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