EHR v Covid-19. Trends in testing, telehealth, hospitalizations

Welcome back to Where does the data lead?!

Here we are eight plus months into the pandemic and our testing volume and our positivity rates have been up and down. Testing volumes have varied because of limitations on receiving re-agents for our labs to process the specimens. It does appear that our test positivity rate, on the red line above, is increasing this month. This is also concordant with our Colorado state level data.

During this time, UCHealth has continued to grow as a system. We have opened a few new facilities in the past year, so the clinic volume, the patient population we serve, as well as the test volume has increased. So, lots going on here, and probably no one factor explains the pattern.

Visit Volumes at UCHealth

Our in-person visit volume for 2020 showed that precipitous drop in mid March (light red) and then nadir at mid April, with gradual recovery to 90% volume by July. At the same time (light green), our telehealth volume exploded at the same time, from a baseline of 20 visits a day, reaching a peak of about 4000 visits a day by mid April. As we figured out how to see patients safely in clinic, our in-person visits gradually returned and our telehealth volume declined, and we are now steady-state at about 1000 telehealth video-visits per day. Magenta is the scheduled telephone visits, a new visit type that Medicare began reimbursing. Blue is the regular telephone volume, essentially unchanged. The dark red is a gradual but consistent increase in patient portal messages, both gratifying that our patients have found a way to connect with their provider, and also worrisome in that this near-doubling of volume does impact the unreimbursed workload of providers in our system.

Cliffhanger

We are now back to our “cliffhanger” TV series. What will happen tomorrow? UCHealth has restarted our Incident Command Center given the increase in hospitalizations. Like many hospitals around the country, we are seeing a bump in inpatients with COVID-19. We had a peak of about 120 in April, then gradually fallen to a nadir of 17 inpatients in late summer, and are back up to mid 50’s this week, and rising.