In-Person Outreach And Telemedicine In Liver And Intestinal Transplant: A Survey Of National Practices, Impact Of COVID-19 And Areas Of Opportunity

Abstract [from journal]

Little is known about national practices and use of in-person outreach clinics and telemedicine in transplantation. We initially aimed to assess contemporary use of in-person outreach and telemedicine in liver and intestinal transplantation in the U.S. We conducted a national survey of liver and intestinal transplant programs to assess use of outreach and telemedicine from January to March of 2019. Given the coronavirus disease 2019 (COVID-19) pandemic, we distributed a second survey wave in April 2020 to assess changes in telemedicine use. Of the 143 programs surveyed, the initial response rate was 51% (n=73) representing all 11 Organ Procurement and Transplantation Network (OPTN) regions and 29 states. Pre-COVID-19, a total of 42 (59%) surveyed programs had in-person outreach clinics only while 12 (16%) programs in only 6 states used telemedicine. Centers with higher median MELD at transplant were more likely to utilize telemedicine (p=0.02). During the COVID-19 pandemic, among 55 of the 73 original responding programs (75%) from all 11 OPTN regions, telemedicine use increased from 16% to 98% and was used throughout all phases of transplant care. Telemedicine utilization was very low prior to COVID-19 and has increased rapidly across all phases of transplant care presenting an opportunity to advocate for sustained future use.