Using telemedicine and virtual healthcare to improve clinical follow-up for survivors of sexual assault and intimate partner violence: a 7-year investigation of emergency department cases.

Abstract

Introduction: The primary objective was to evaluate the effectiveness of telemedicine for improving clinical follow-up for survivors of sexual assault and intimate partner violence after an emergency department (ED) visit. The Sexual Assault and Partner Abuse Care Program (SAPACP) is an ED-based clinic for survivors of sexual assault/intimate partner violence. Virtual Visit, a telemedicine platform, was introduced at SAPACP in January 2020, allowing patients to attend follow-up virtually.

Methods: This is a seven-year analysis of sexual assault/intimate partner violence cases presenting to an ED from 1 Jan 2015 to 31 Mar 2022. Interrupted time series and segmented linear regression models with a first lag autoregressive covariance structure were used to analyze follow-up rates post-Virtual Visit and to predict a counterfactual trend.

Results: Between 2015 and 2022, there were 3317 sexual assault/intimate partner violence case visits, with 2406 visits being pre-Virtual Visit (1 Jan 2015-31 Dec 2019) and 911 visits post-Virtual Visit (1 Jun 2020-31 Mar 2022). Within the 911 post-Virtual Visit visits, 315 (35%) had virtual follow-ups, 291 (32%) had in-person follow-ups, and 305 (33%) did not return for follow-up. Post-Virtual Visit, there was an immediate 10% increase in the proportion of overall follow-ups while accounting for pre-Virtual Visit trends, which was sustained over two years. The proportion of overall follow-up pre-Virtual Visit was 48% (95% CI: 46.0-50.0%), and was 70.0% (95.0% CI: 67.0-73.0%) post-Virtual Visit. Looking at sub-groups, follow-up for sexual assault cases reached 75.0% (95% CI: 71.0-78.0%) and physical/verbal cases reached 64.0% (95% CI: 60.0-69.0%) post-Virtual Visit.

Conclusion: The implementation of Virtual Visit led to an immediate 10% increase in the proportion of overall follow-ups, which was sustained over a two-year period, while accounting for pre-Virtual Visit trends. These findings indicate that telemedicine can help improve clinical follow-up among survivors of sexual assault/intimate partner violence.