Telehealth Cut Missed Appointments Among Kids With TB by 11%

March 21, 2022 - The implementation of telehealth had a significant impact on missed follow-up appointments among pediatric patients with tuberculosis infections (TBI), reducing the rate of missed visits by 11.1 percent, a study published in the journal Tropical Medicine and Infectious Disease showed.  

TB infections occur in about a quarter of people globally. Although the percentage of individuals with TBI who develop an active case of the infection is much lower at 5 to 15 percent, some factors limit treatment, specifically for pediatric patients.

The study subjects received care at the Yale Pediatric Winchester Chest Tuberculosis Clinic and were younger than 18 years. The data collected for the study related to demographics and the number of missed appointments and therapy completions by each patient.

During the study period, the expansion of the clinic and the COVID-19 pandemic led to telehealth implementation for follow-up visits. Researchers evaluated the effect of telehealth on the clinic one year later.

Before implementing telehealth, 16.9 percent of TBI patients missed appointments between 2016 and 2019.

In 2021, after telehealth services were implemented, 54.2 percent of follow-up TBI visits took place virtually. The missed follow-up appointment rate for children with TBI declined from 16.9 percent to 5.8 percent.

Further, study results showed no significant difference in missed appointment rates between in-person and telehealth services. Patients missed 5.3 percent of in-person appointments and 7.1 percent of telehealth visits in 2021.

Regarding demographics, researchers noticed that primary language affected the number of appointments missed before the implementation of telehealth. In total, 51.6 percent of all patients missed at least one appointment. However, patients who spoke a primary language other than English and Spanish missed 32.8 percent of visits.

Referral by a primary care provider was also linked to a lower likelihood of missing appointments.

Research has shown the positive impact of follow-up care on patient outcomes. A study recently published in the Journal of the America Heart Association examined the correlation between care setting and readmission rate among heart failure patients. Researchers found no significant differences in readmissions among patients who had virtual or in-person follow-ups. On the other hand, the readmission rate was significantly higher among those who did not participate in a follow-up appointment at all.

But the jury is still out on whether patients are more likely to miss telehealth or in-person visits. Though the pediatric TBI study shows that the missed appointment rate was similar for in-person care and telehealth, previous data reveals that this is not always the case. A survey conducted last summer shows 45 percent of 624 providers reported that telehealth no-show rates were higher or much higher than in-person no-show rates, while only 22 percent said the rates were equal.

Following the acknowledgment of the harm it brings, UPMC described how this problem could be reduced through processes such as overbooking and reminding patients of their appointments.