Background: Physical distancing and visiting restrictions during the COVID-19 pandemic particullarly posed significant challenges in providing timely medical care in nursing homes. Virtual visits were pivotal in providing both scheduled and urgent patient care in addition to in-person care when possible. These virtual visits could have been used to provide urgent medical care than the regular scheduled visits. We hypothesize that regular non-COVID-19-related virtual visits in the evaluated nursing home facilities were lower than COVID-19-related virtual visits during this period. The objective was to compare the frequency of COVID-19-related virtual visits with non-COVID-19-related virtual visits performed in three suburban nursing homes in Michigan from December 2020 through February 2022. Methods: Retrospective chart review of 283 patients, comprising 563 virtual visits. The most frequent ICD-10 diagnostic codes used by providers for primary encounters were analyzed for three participating facilities Results: Only 13.8% (78/563) of all virtual visits during the study period were for COVID-19 as a primary encounter. In total 86.1% (485/563) of visits were non-COVID-19 related, which comprised most frequently M6281 muscle weakness (45), E119 diabetes type with complications (20), NI86 end-stage renal disease (11), N390 urinary tract infection (10), G309 Alzheimer's disease (10), and I4891 unspecified atrial fibrillation (10). Conclusion: We found that the primary ICD-10 diagnosis codes for virtual COVID-19-related visits were significantly lower than non-COVID-19-related virtual visits in our study population. This trend could be associated with multiple system-based factors. Further studies to examine factors responsible for these findings are warranted.
Keywords: COVID-19 pandemic; ICD-10; nursing homes; telemedicine; urgent visits; workforce.