Impact of the covid-19 pandemic on telemedicine utilization among us sleep fellowship programs

SESSION TITLE: Sleep and Health Determinants SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Evaluate the influence of the COVID-19 pandemic on (1) telemedicine utilization in sleep fellowship programs and (2) sleep fellowship program directors’ (PDs’) attitudes towards development of a standardized telemedicine curriculum, while comparing these findings to a similar 2019, pre-pandemic survey of PDs. METHODS: We created a 33-item survey using the SurveyMonkey platform. The survey input was blinded, and the investigators had no access to individual respondent data. Participants completed a series of items with branching logic. Qualitative data collected from an open-ended question underwent thematic analyses using commonly utilized codebook methodology. The study protocol was approved by the Emory University Institutional Review Board. RESULTS: Forty-one (45%) sleep medicine fellowship PDs completed the survey. Of them, 40 (97.5%) indicated that their program offers its fellows experience in sleep telemedicine. Ten of these PDs (25%) offered this experience prior to the Covid-19 pandemic, indicating a 400% increase in telemedicine usage among the programs whose PDs completed the survey. Twenty-three (57.5%) PDs required telemedicine as a standard part of training, whereas only 8 (20%) of them required it before the Covid-19 pandemic. Although 26 (65%) PDs agreed or strongly agreed that sleep telemedicine training is an important part of the fellowship program, only 8 (20%) of them offered a sleep telemedicine curriculum. Nevertheless, 27 (67.5%) PDs agreed that a national telemedicine curriculum could be useful. Fourteen (34.2%) PDs reviewed the original 2016 AASM Sleep Telemedicine Implementation Guide, and 13 (31.7%) PDs reviewed updated 2021 AASM Sleep Telemedicine Implementation guide. Thematic analysis of the qualitative data revealed varying PD opinions about developing a standardized telemedicine curriculum, ranging from encouragement to develop an online, free interactive curriculum to doubtful attitudes about how a telemedicine curriculum could be useful. CONCLUSIONS: The COVID-19 pandemic has hastened telemedicine’s acceptance and use into mainstream medicine. The increased utilization requires that healthcare practitioners exhibit proficiency in this care model. While our intra-pandemic 2022 survey shows many more programs utilizing telemedicine compared to our pre-pandemic 2019 survey, PDs’ attitudes toward a national sleep curriculum have not changed significantly. Some PDs may not perceive the need to implement a telemedicine curriculum when it is already being used extensively, as opposed to when it was only rarely used; their limited review of freely-available resources provided by the AASM may suggest their own limited knowledge of telemedicine complexities. More efforts could be made nationally to ensure that PDs are aware of such resources and their utility. Limitations of the study include (1) lack of ascertainment of PDs’ opinions about telemedicine’s financial and technical feasibility; (2) sampling error; and (3) a possible response bias, which can limit the generalizability of these findings. CLINICAL IMPLICATIONS: Given the widespread utilization of telemedicine in the sleep fellowship programs, along with inherent complexities deploying this care model, implementation of an organized and cohesive telemedicine curriculum may be useful. Future studies could address development and implementation of standardized sleep telemedicine curricula in order to prepare physicians in training for provision of efficient, ethical and high-value twenty-first century patient care. DISCLOSURES: No relevant relationships by Swapan Dholakia No relevant relationships by Barry Fields No relevant relationships by Octavian Ioachimescu No relevant relationships by Komal Kaur