# Improving Safe Antibiotic Prescribing in Telehealth: A Randomized Trial

> **NIH AHRQ R01** · YALE UNIVERSITY · 2022 · $276,118

## Abstract

ABSTRACT
The purpose of this one-year supplement is to understand the role of telehealth in public health surveillance
and health outcomes in the COVID-19 pandemic. Our parent project (R01HS026506), developing and
evaluating interventions to promote antibiotic stewardship in telehealth, is of both direct and indirect import.
Appropriate use of antibiotics is a textbook model of promoting evidence-based practice. However, COVID-19
has put a spotlight on the need to implement a surveillance and dissemination system for emerging evidence.
Concern over the safety of in-person visits and concurrent changes in policies have resulted in unprecedented
uptake of telehealth in 2020. Telehealth service providers with national penetration are uniquely positioned for
near real-time surveillance of public health and clinician response. In a one-month monitoring period starting
March 1, 2020, over 21,546 Teladoc® patients were clinically diagnosed or deemed to have high-risk exposure
to a known COVID-19 case. By incorporating outcomes from claims data and new knowledge into our existing
system, we have the opportunity to rapidly update and disseminate evidence. Our analysis environment links
the Teladoc® electronic medical record with continuous updates of over 1.7 million beneficiaries’ data since
2018. This linked longitudinal data set includes both telehealth and non-telehealth users. This supports
analysis of outcome differences and associated changes before and after the pandemic. The first objective in
this one-year supplement will advance our collaboration with the public health agencies to assess the value of
this data in syndromic surveillance. Second, we will extend our antibiotic practice variation monitoring to
include additional practices, including off-label prescribing and referral patterns for suspected COVID-19
patients. The third and fourth objectives will assess the feasibility of two causal inference studies using
outcomes from claims, including an investigation of the impact that utilization changes have had on AHRQ
Ambulatory Care Sensitive Conditions and disparities. Our work will have immediate impact on public health
and service delivery, using an integrated system for developing and disseminating COVID-19 evidence in the
largest and most geographically diverse telehealth provider in the US.

## Key facts

- **NIH application ID:** 10915055
- **Project number:** 7R01HS026506-06
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Daniella Meeker
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $276,118
- **Award type:** 7
- **Project period:** 2018-09-30 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10915055

## Citation

> US National Institutes of Health, RePORTER application 10915055, Improving Safe Antibiotic Prescribing in Telehealth: A Randomized Trial (7R01HS026506-06). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10915055. Licensed CC0.

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