ID: 3524374 IMPACT OF SARS-COV-2 PANDEMIC ON TURNOVER TIME AND REVENUE IN THE ENDOSCOPY UNIT: SINGLE CENTER EXPERIENCE

Abstract

Table 2. Descriptive table with univariate analyses (Chi-square) assessing effect of endoscopy factors on gastrointestinal endoscopic healthcare worker (GIE-HCW) COVID-19 infection. Dyads are defined as GIE-HCW matched to their specific patient endoscopic exposures in the study period. *p<0.05. +Endoscopy duration NZ51. ++Endoscopy duration NZ49. +++Endoscopy duration NZ2. FRIDAY, MAY 21, 2021jSATURDAY, MAY 22, 2021 Clinical Endoscopic Practice 2 LecturejLecture ID: 3521475 COMPARING PATIENT SATISFACTION AMONG TELEMEDICINE, DIRECT ACCESS, AND IN-PERSON CLINIC PRE-PROCEDURE VISITS FOR GASTROINTESTINAL ADVANCED ENDOSCOPIC PROCEDURES Diana Wee*, Xiao Li, Kelly Suchman, Arvind J. Trindade Background and aims: With the onset of the Coronavirus Disease 2019 (COVID-19) pandemic, healthcare providers abruptly changed their delivery of care to protect patients and staff from infection. One such change was to convert in-person advanced gastrointestinal endoscopy pre-procedure consultations to telemedicine visits. The use of telemedicine has been successfully used in the field of gastroenterology in managing symptoms and chronic conditions among established patients. However, to our knowledge, there is little literature on the utility of this modality for pre-procedure consultation visits, where patients often meet their proceduralists for the first time. The aim of this study was to compare overall patient satisfaction among those who had pre-procedure consultation visits by telemedicine, in –person, or a direct access procedure (instructions and procedure explained by a nurse practitioner or physicians assistant). Methods: Patients who had undergone an advanced endoscopic procedure at Long Island Jewish Hospital from the months of May 2020 to August 2020 were called by telephone and asked to complete a modified version of the validated patient satisfaction survey mGHAA-9. The survey was designed to assess patient satisfaction in their pre-procedure, intra-procedure, and post procedure experiences. Patients were grouped based on whether they had received an in-clinic consultation visit by the endoscopist, telemedicine consultation visit by the endoscopist, or direct access. Geographic location to the office, prior endoscopic experience, type of endoscopic procedure (diagnostic vs. therapeutic), and new gastrointestinal cancer diagnosis data were recorded. Results: Of the total 322 patients that were called, 123 agreed to participate (38%) and provided responses to the survey. There were 26 who had in person consultation visits, 32 who had telemedicine consultation visits, and 65 direct AB46 GASTROINTESTINAL ENDOSCOPY Volume 93, No. 6S : 2021 access visits. Overall mean satisfaction among the three groups did not reveal a statistically significant difference (p valueZ 0.983). Furthermore, sub-analysis of the preprocedure, intra procedure, and post procedure satisfaction scores did not reveal statistically significant differences (pZ0.996, pZ0.244, and pZ0.998, respectively). However, patients with a new gastrointestinal cancer diagnosis had a statistically significant higher mean satisfaction score in those who had telemedicine visits with proceduralists compared to those who had direct access procedures (PZ0.0116). Conclusion: Our study suggests that pre-procedure consultation visits by telemedicine, in-person, or direct access all have similar satisfaction scores among patients. However, telemedicine consultation visits with the endoscopist may be preferred over direct access in patients who have a clinically high suspicion for a new gastrointestinal cancer diagnosis. FRIDAY, MAY 21, 2021 Clinical Endoscopic Practice 2 Lecture ID: 3524374 IMPACT OF SARS-COV-2 PANDEMIC ON TURNOVER TIME AND REVENUE IN THE ENDOSCOPY UNIT: SINGLE CENTER EXPERIENCE Abdelhai Abdelqader, Avik Sarkar, Haroon M. Shahid, Amy Tyberg, Sohini Sameera, Mihajlo Gjeorgjievski, Romy Bareket, Daniel Kats, Ping He, Eric Zhao, Monica Gaidhane, Michel Kahaleh* Background and aims: The SARS-CoV-2 pandemic strongly impacted the New York metro area. Many regional private practices and institutions had either significantly reduced case volume or fully closed their endoscopy units, leading to a large influx of patients to our institution. We aimed to analyze the impact of COVID-19 quantitatively and financially on the endoscopy unit at our tertiary care center. Methods: A single center, retrospective chart review was performed to identify all inpatient and outpatient endoscopic procedures between December 1, 2019 – June 30, 2020. The procedures were split into two groups: the COVID-19 lockdown group (March 16, 2020 June 30, 2020) and pre-COVID-19 group (December 1, 2019 March 15, 2020). Quantity of procedures, procedure types, demographics and turn over times (TOT) were obtained. The financial impact was assessed using national averages for reimbursement of outpatient endoscopic procedures provided by Center for Medicare and Medicaid Services1-5. Two-sample t-test was conducted to compare turnover time. Results: A total of 3622 procedures were performed during the study period: 2297 in the pre-COVID-19 period, 1325 in the COVID-19 lockdown group representing a 42.32% decrease. The quantity of both general and interventional endoscopic procedures decreased (Figure 1). In both groups, nearly 50% patients were male and average age was 59. The available mean TOT increased (41.5 minutes to 59.5 minutes) from pre-COVID-19 to during COVID-19 group (Table 1). During COVID, there was a significant increase in TOT in both the general endoscopy cases (18.11 minutes, p valueZ0.000) and advanced endoscopy cases (17.7 minutes, p valueZ0.000) groups compared to preCOVID phase turnover time (Table 1). During COVID-19, the TOT between general to interventional cases was statistically significant (9.79 minutes, p valueZ0.012) (Table 1). The 42.3% decrease in volume equated to at least $1.6 million USD in lost revenue. This represented $960,000 USD from general endoscopy cases and $963,000 USD from interventional cases. Among 8 endoscopists, 5 became COVID-19 positive during the lockdown, but none requiring hospitalization. Conclusions: The COVID-19 pandemic lead to an increase in TOT with overall reduced quantity of endoscopic procedures with a negative impact on revenue. However, maintaining a restricted but functioning endoscopy unit provided needed patient care and avoided difficulties and delay in