TRAITS OF PATIENTS SEEN VIA TELEMEDICINE VERSUS IN-PERSON FOR NEW PATIENT VISITS IN A FERTILITY PRACTICE

Objective: Integration of telemedicine (TM) into reproductive endocrinology and infertility (REI) is quickly occurring due to changes in the practice environment and recently, COVID19 However, no US studies have investigated telemedicine’s impact on REI practices This study aimed to evaluate differences in demographics, time to treatment initiation, clinical outcomes, and dropout rates between patients using telemedicine relative to in-person (IP) visits Design: Retrospective cohort study Materials and Methods: All new patients seen via TM (between June 2017 to February 2020) at an academic practice were compared with control new IP visits (seen in 2019) The following were evaluated for each new patient encounter by visit type (TM or IP): demographics, cancellation, distance to clinic, infertility diagnosis, duration of infertility, time to treatment initiation, number of clinic-contacts (i e number of e-messages or phone calls from patient) prior to treatment start, and dropout rate We performed t-test analysis by group for continuous independent variables and Chi-square analyses by group for categorical independent variables Binary logistic regression analysis was performed to estimate the odds of initiating treatment in the TM group Results: Seventy-one patients were identified in the TM group, and 71 followed in the IP group The average age of the IP and TM groups was similar, at 33 5 ± 5 0 and 33 2 ± 5 2, respectively (p=0 723) There were no differences between groups in the following: BMI (p=0 723), area deprivation index (p=0 235), and treatment recommended (e g ovulation induction, IVF, surgery, etc ) (p=0 475) There were no differences between the TM and IP groups in: treatment dropout rates (p=0 075), cancellation rates (p=0 379), time to treatment initiation (mean 74 82 days in TM group;77 5 days in IP group;p = 0 315), or number of times the patient contacted the clinic prior to treatment start (p=0 153) Of those who became pregnant, time to positive pregnancy test was not significantly different between the TM (n=11, mean 176 4 days) and IP groups (n=19, mean 226 45 days) (p=0 368) Compared to IP patients, TM patients were significantly more likely to live further away (mean 223 6 miles vs 69 28 miles, p = 0 006) and have a longer duration of infertility (mean 41 9 months vs 19 49 months, p = 0 006) The lengths of TM appointments were significantly shorter than IP visits (mean 56 3 ± 9 1 minutes vs 59 3 ± 4 6 minutes, p < 0 001) and much less likely to contain documentation of height or weight (p=0 001) In the TM group, age and distance from clinic were not significantly associated with likelihood of dropping out of treatment (p=0 467) Conclusions: Telemedicine appears to be of particular interest to patients who live further from clinics and have longer durations of infertility, and it could help reduce visit times Patients seen in person and via telemedicine are equally likely to pursue treatment Telemedicine consultation for new-patient visits is feasible in REI practice and is especially useful in areas with limited access to fertility specialists and beyond in a post-COVID landscape