Feasibility of and Experience With Free State-Funded Telehealth-Based Patient Self-referral for COVID-19 Monoclonal Antibody Therapy

Disaster Med Public Health Prep. 2023 Sep 13:18:e110. doi: 10.1017/dmp.2023.154.

Abstract

Background: Monoclonal antibody (mAb) treatment for coronavirus disease 2019 (COVID-19) has been underutilized due to logistical challenges, lack of access, and variable treatment awareness among patients and health-care professionals. The use of telehealth during the pandemic provides an opportunity to increase access to COVID-19 care.

Methods: This is a single-center descriptive study of telehealth-based patient self-referral for mAb therapy between March 1, 2021, and October 31, 2021, at Baltimore Convention Center Field Hospital (BCCFH).

Results: Among the 1001 self-referral patients, the mean age was 47, and most were female (57%). White (66%), and had a primary care provider (PCP) (62%). During the study period, self-referrals increased from 14/mo in March to 427 in October resulting in a 30-fold increase. Approximately 57% of self-referred patients received a telehealth visit, and of those 82% of patients received mAb infusion therapy. The median time from self-referral to onsite infusion was 2 d (1-3 IQR).

Discussion: Our study shows the integration of telehealth with a self-referral process improved access to mAb infusion. A high proportion of self-referrals were appropriate and led to timely treatment. This approach helped those without traditional avenues for care and avoided potential delay for patients seeking referral from their PCPs.

Keywords: COVID-19; monoclonal antibody; self-referral; telehealth; utilization.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal* / therapeutic use
  • Baltimore
  • COVID-19 Drug Treatment
  • COVID-19* / therapy
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Referral and Consultation* / statistics & numerical data
  • SARS-CoV-2*
  • Telemedicine* / statistics & numerical data

Substances

  • Antibodies, Monoclonal