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Primary care loop closure low across all test types
Rates of loop closure are low for all test types across all primary care visit modalities but are worse for telehealth visits, according to a study published online Nov. 15 in JAMA Network Open.
Anthony Zhong, from Harvard Medical School in Boston, and colleagues examined the prevalence of diagnostic loop closure for tests and referrals ordered at telehealth visits versus in-person visits. The analysis included test and referral orders for 4,133 patient visits from March 1, 2020, to Dec. 31, 2021, at a large urban hospital-based primary care practice and one affiliated community health center.
The researchers found that 27.8 percent of orders were placed during a telehealth visit, and of the telehealth orders, 42.6 percent were completed within the designated time frame versus 58.4 percent of those ordered during in-person visits and 57.4 percent of those ordered without a visit. In the adjusted analysis, patients with telehealth visits were still less likely to close the loop for all test types versus those with in-person visits (odds ratio, 0.55).
"Failure to close diagnostic loops presents a patient safety challenge in primary care that may be of particular concern during telehealth encounters," the authors write.
More information: Anthony Zhong et al, Completion of Recommended Tests and Referrals in Telehealth vs In-Person Visits, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.43417
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