OBJECTIVES:

To describe care utilization types and related imaging utilization outcomes during the COVID pandemic.

METHODS:

Electronic Health Record (EHR) data from four participating MS-CQI centers was abstracted for January-June 2020. Participants were patients with Multiple Sclerosis (PwMS) ≥18 years who were seen either in person or via a telehealth method such as phone or video. Chi-square tests were used to assess associations across centers and different types of telehealth utilization variables. ANOVA was used for continuous variables. Associations between 3 types of magnetic resonance imaging (MRI) utilizations [brain MRI (bMRI), cervical MRI (cMRI), and thoracic MRI (tMRI)] and care delivery type (telehealth or in-person) were assessed using binary logistic regression.

RESULTS:

The study included 1,866 PwMS with the majority being female (75%), having RRMS (81%), and an average age of 49 years. 1,014 patients used a telehealth method during the time period whereas 852 patients utilized in-person physician visits. Controlling for covariates, regression analyses identified significant center effects on MRI imaging usage during the pandemic. Telehealth utilizers had greater odds of using imaging services compared to in-person utilizers for brain MRI (bMRI), cervical MRI (cMRI), and thoracic MRI (tMRI) respectively (bMRI OR 3.48; 95% CI: 2.51-4.82; cMRI OR 2.93; 95% CI: 1.94-4.45; tMRI OR 2.50; 95% CI: 1.51-4.14).

CONCLUSIONS:

MRI plays a large role in how MS specialists diagnose, treat, and monitor MS. We found that telehealth patients had greater odds of MRI utilization. Due to data limitations, we were unable to control for all potential influencing factors. However, our results suggest future inquiry targeting the differences in patient care practices based on care delivery type related to imaging utilization and related MS population health outcomes.