54 From the COVID-19 Epicenter: Using Telemedicine to Serve the Needs of the Geriatric Population

Study Objectives: The COVID-19 pandemic is responsible for over 400,000 deaths worldwide with New York City (NYC) as the epicenter of the pandemic in the United States Geriatric patients were at especially high risk As of June 2020, the New York City cumulative death rate by age: \u003e 75 years was 1535/100 K population, while for 45-64 years it was 187/100 K population Telemedicine (TH) was used as a tool to shift non-emergent care from overburdened emergency departments and to provide routine and urgent health care to the community who were directed to self-isolate and often fearful of seeking care during the pandemic While offering the ability to reach many patients, remote health care options presented unique challenges due to technology requirements, visual, hearing, cognitive and often language limitations in our diverse multilingual geriatric community Our study’s goal was to evaluate the use of remote health care during the COVID-19 pandemic in NYC at our institution We compared the frequency of geriatric use during the flu season with a similar interval during the pandemic Methods: We conducted a retrospective chart review of patients 65 and older who were evaluated remotely by a ED provider on a telemedicine platform that was accessible on a desktop or mobile phone (TH) during the local pandemic surge: from 3/1 to 4/30 2020 at a hospital in northern Manhattan/NYC Chart extraction methods were developed and performed by 5 emergency physicians Categories and characteristics were defined in advance and included demographics, technical limitations, referral to ED, and death occurring during the time of the chart review Results: During the pandemic study period a total of 140 charts were extracted The mean age was 73 Overall, 20% of patients in the cohort were advised to seek emergent care Same day emergent care referral occurred in 12% (65-75yrs), 36% in (76-85 yrs) and 61% (\u003e85 yrs) We found significant growth in use of TH from pre-pandemic (12/1 to 1/23/2019), 7 patients \u003e65 years utilized the TH platform while during the pandemic (3/1 - 4/23/2020), 130 patients over the age of 65 utilized TH to access health care Conclusion: Geriatric Telemedicine showed an exponential growth during the pandemic TH program efforts to promote its use to redirect patients away from the ED were successful Given the rate of same day emergent referrals there was a variable level of acuity that reinforces the need to have telehealth providers that are trained in triage and emergency medicine with a knowledge of local resource availability