To determine if virtual visits prevented patient visits to the emergency department (ED) and whether patients found virtual visits a satisfactory replacement of an in-person visit.

Data from virtual visits were collected from March-May 2020 when the clinic reopened. Follow-up visits were analyzed by success rate, average visit time, intervention and presentation to ED from March-June 2020. Post-visit, patients were contacted for a follow-up survey. The statistical analysis was carried out by Chi-square, ANNOVA, Kruskal-Wallis and Fisher’s exact t-tests.

We contacted 152 of 216 patients scheduled for follow-up (70.4%). Virtual visits were conducted in 134 patients. Mean age was 47.5 years (range 20-80), two-thirds were female (68%). Sixty-nine patients were Hispanic(51.2%); 51 were African-American(38.1%). Average visit duration was 14.9 minutes. Most common diagnoses were headache(31.3%), epilepsy(20.2%) and demyelinating disorders(13.4%). Most patients did not require change in management and received medication refills with routine follow-up (61%). They were more likely to have headache or epilepsy (p=0.007). A change in medication/investigation/expedited follow-up was needed for 35% of patients. The most common diagnosis for this group was demyelinating, movement or neuromuscular disorder. Two patients visited our ED, 1 had respiratory symptoms and the other had a neurological symptom. Virtual visits were considered satisfactory by 86% of patients. Race(p=0.98), language(p=0.91), neurological diagnosis(p=0.45) and actions taken(p=0.31) did not influence satisfaction rates.

We believe that the alternate workflow in the neurology clinic during the COVID-19 pandemic prevented unnecessary ED visits. Patient satisfaction with the visits was high (86%).