TY  - JOUR
AU  - Chen, Ying-Hsien
AU  - Wu, Hui-Wen
AU  - Huang, Ching-Chang
AU  - Lee, Jen-Kuang
AU  - Yang, Li-Tan
AU  - Hsu, Tse-Pin
AU  - Hung, Chi-Sheng
AU  - Ho, Yi-Lwun
PY  - 2022
DA  - 2022/6/10
TI  - The Logistics of Medication and Patient Flow in Video-Based Virtual Clinics During a Sudden COVID-19 Outbreak in Taiwan: Observational Study
JO  - Interact J Med Res
SP  - e37880
VL  - 11
IS  - 1
KW  - COVID-19
KW  - telemedicine
KW  - video-based virtual clinic
AB  - Background: The COVID-19 pandemic was well controlled in Taiwan until an outbreak in May 2021. Telemedicine was rapidly implemented to avoid further patient exposure and to unload the already burdened medical system. Objective: To understand the effect of COVID-19 on the implementation of video-based virtual clinic visits during this outbreak, we analyzed the logistics of prescribing medications and patient flow for such virtual visits at a tertiary medical center. Methods: We retrospectively collected information on video-based virtual clinic visits and face-to-face outpatient visits from May 1 to August 31, 2021, from the administrative database at National Taiwan University Hospital. The number of daily new confirmed COVID-19 cases in Taiwan was obtained from an open resource. Results: There were 782 virtual clinic visits during these 3 months, mostly for the departments of internal medicine, neurology, and surgery. The 3 most common categories of medications prescribed were cardiovascular, diabetic, and gastrointestinal, of which cardiovascular medications comprised around one-third of all medications prescribed during virtual clinic visits. The number of virtual clinic visits was significantly correlated with the number of daily new confirmed COVID-19 cases, with approximately a 20-day delay (correlation coefficient 0.735; P<.001). The patient waiting time for video-based virtual clinic visits was significantly shorter compared with face-to-face clinic visits during the same period (median 3, IQR 2-6 min vs median 20, IQR 9-42 min; rank sum P<.001). Although the time saved was appreciated by the patients, online payment with direct delivery of medications without the need to visit a hospital was still their major concern. Conclusions: Our data showed that video-based virtual clinics can be implemented rapidly after a COVID-19 outbreak. The virtual clinics were efficient, as demonstrated by the significantly reduced waiting time. However, there are still some barriers to the large-scale implementation of video-based virtual clinics. Better preparation is required to improve performance in possible future large outbreaks. 
SN  - 1929-073X
UR  - https://www.i-jmr.org/2022/1/e37880
UR  - https://doi.org/10.2196/37880
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35687404
DO  - 10.2196/37880
ID  - info:doi/10.2196/37880
ER  -