Factors Affecting Patient Perceptions and Satisfaction with Telemedicine in Outpatient Clinics

Breaking the Emergency Room Cycle: The Impact of Telemedicine on Emergency Department Utilization

Background Telemedicine has gained prominence in healthcare, and understanding its impact on diverting non-urgent cases from the emergency room (ER) has become crucial. This study delves into the dynamic relationship between telemedicine utilization and ER visits, seeking to understand the transformative impact of telehealth on breaking the traditional ER cycle. Method To explore the awareness and utilization of telemedicine services in the broader population of Saudi Arabia, we adopted a cross-sectional design utilizing the convenience sampling method. Data collection was facilitated through a self-administered online survey comprising four sections: demographic variables, ER visits, awareness of non-urgent cases, and suggestions. The collected data were entered into IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States) for descriptive analysis. Results Among the 1140 participants, the majority were females (56.8%), with 43.2% being males. Regarding age distribution, the highest percentage fell within the 18-25 age group (46.8%). Nationality-wise, a substantial proportion identified as Saudi (95.2%). Educational backgrounds varied, with 60.7% holding a bachelor's degree. Notably, 62.6% of the visits were classified as urgent. A significant portion (66.8%) demonstrated awareness of alternative options for non-urgent care, such as outpatient clinics and telemedicine services. Specifically regarding telemedicine, 82.8% of respondents believed that video consultations and prescription refills could effectively address non-urgent conditions. Furthermore, 89.6% of participants agreed that educating patients on self-care and home remedies could help manage symptoms and deter unnecessary ER visits. Conclusions The positive reception of telemedicine, as evidenced by high satisfaction rates among participants, further reinforces its role in reshaping the landscape of healthcare delivery.

Empirical Evidence of Internal and External Factors Influencing Users' Motivation Toward Teleconsultation Use

Introduction: The use of teleconsultation systems has increased in recent years, which has improved patients' access to health care providers and enabled seamless interaction between them. The literature points out several factors that either facilitate or impede the use of teleconsultation. However, there is a lack of studies that provide empirical evidence of factors that influence consumers' motivation toward the use of teleconsultation systems. Aim and Objective: This study aimed to provide empirical evidence of the internal and external factors that influence consumers' motivation toward the use of teleconsultation systems. Methods: A cross-sectional survey was used to collect data from consumers who used a real-time teleconsultation system called the Sehha application in Saudi Arabia between March 13 and June 14, 2021. SPSS 27.0.1 was used for descriptive analysis. Results: Four hundred eighty-five participants completed the survey, 471 of whom were included in the analysis. The findings confirmed that internal and external factors exert an influence on consumers' motivation toward the use of teleconsultation systems. The findings indicated that the presence of factors such as saving time, saving cost, accessibility to health care, ease-of-use, reliable internet access, availability of devices, and appropriate places during the online connection would increase consumers' motivation toward teleconsultation systems use. Also, the findings indicated that users' familiarity with systems similar to teleconsultation systems, users' perception of teleconsultation convenience, the influence of others on users' decision to use teleconsultation, and user's skills and confidence in using teleconsultation easily, and their trust in the teleconsultation system would also increase their motivation to use it. Furthermore, the findings showed that demographic factors, including age, gender, level of education, and employment status, did not influence users' motivation toward the use of teleconsultation Conclusions: This study provided empirical evidence of a variety of internal and external factors that exert an influence on consumers' motivation toward the use of teleconsultation systems.

Patient Experiences with and Preferences for Telemedicine Relative to In-Person Care During the COVID-19 Pandemic

Introduction: Although telemedicine emerged during the COVID-19 pandemic as a critical mode of health care delivery, there may be differences in the perceived ease of patient-clinician communication and quality of care for telemedicine versus in-person visits, as well as variation in perceptions across patient subgroups. We examined patients' experiences with and preferences for telemedicine relative to in-person care, based on their most recent visit. Methods: We conducted a survey of 2,668 adults in a large academic health care system in November 2021. The survey captured patients' reasons for their most recent visit, perceptions on patient-clinician communication and quality of care, and attitudes toward telemedicine versus in-person care. Results: Among respondents, 552 (21%) had a telemedicine visit. Patients with telemedicine and in-person visits had similar agreement on ease of patient-clinician communication and perceived quality of the visit on average. However, for individuals 65 years of age or older, men, and those not needing urgent care, telemedicine was associated with worse perceptions of patient-clinician communication (65 years of age or older: adjusted odds ratio [aOR], 0.51; 95% confidence interval [CI], 0.31-0.85; men: aOR, 0.50; 95% CI, 0.31-0.81; urgent care: aOR 0.67; 95% CI, 0.49-0.91) and lower perceived quality (65 years of age or older, aOR 0.51; 95% CI, 0.30-0.86; men: 0.51; 95% CI, 0.32-0.83; urgent care: aOR 0.68; 95% CI, 0.49-0.93). Conclusion: Patient-perceived quality of care and patient-clinician communication were similar for telemedicine and in-person visits overall. However, among men, older adults, and those not seeking urgent care, patients using telemedicine had lower perceptions of patient-clinician communication and quality.

Comparison of patient responses to telehealth satisfaction surveys in rural and urban populations in Queensland

Objective Telehealth has for many years been identified as a potential contributor to reducing healthcare access inequality. For these benefits to be realised, patients must be accepting and satisfied with the delivery of healthcare in this manner. Measuring patient satisfaction across a large geographical area is important to ensure that investments in telehealth are delivering the benefits that are intended. Methods A brief survey was automatically issued on completion of a patient's telehealth appointment, requesting patient feedback on their experience and information on the location of where they participated in the appointment. These results were compared to an article review which sought examples of other patient satisfaction measures that compared rural and urban populations. Results No significant correlations between survey responses and established demographic indices were found. When stratified by the Modified Monash Model band from which the patient participated in their telehealth appointment from, an ANOVA test determined that rurality was not a predictor of survey response. A review of articles found four articles that compared rural and urban satisfaction responses. Conclusion No evidence of a patient's location influencing their satisfaction with telehealth was observed. This may be attributed to a variety of technical improvements introduced over the past 5-10 years that have made participating in telehealth appointments less technically demanding and more accessible. Telehealth is likely to be contributing to a reduction in healthcare access inequality in Queensland.

Interobserver Agreement and Satisfaction With the use of Telemedicine for Evaluating low Back Pain: A Primary, Observational, Cross-Sectional, Analytical Study

STUDY DESIGN

A primary, observational, cross-sectional, analytical study.

OBJECTIVE

The development of a framework for systematic telemedicine (TM) for orthopedic physicians in frequent clinical care may increase agreement in diagnosis and satisfaction among users of TM. Therefore, this study aimed to estimate the agreement in the diagnosis of low back pain (LBP) between TM, systematized by a self-completed digital questionnaire, and face-to-face (FF) care in patients with LBP.

METHODS

This study included adults up to 75 years of age with LBP for more than 6 weeks. They were evaluated at 2 independent time points (TM and FF) by different orthopedists with 3 different levels of expertise. Professionals evaluated the sample without prior knowledge of the diagnosis, and each orthopedist provided a diagnosis. Diagnostic agreement was the primary outcome. Secondary outcomes were the duration of the visit and satisfaction among healthcare professionals.

RESULTS

A total of 168 participants were eligible, of whom 126 sought care through TM and 122 sought FF care (mean age, 47 years [range, 18-75 years]; 66.4% women). The agreement among professionals regarding the diagnosis was moderate (kappa = .585, P = .001). TM was faster than FF (11.9 minutes (standard deviation = 4.1) vs 18.6 (SD = 6.9), P < .001). Professional satisfaction was higher among spine specialists than among orthopedic residents and orthopedists who were not specialists in spine surgery.

CONCLUSION

Agreement in diagnosis was moderate for TM, with a 30% shorter visit duration than FF. Satisfaction varied by professional expertise and was higher among spine specialists than among professionals with other expertise.

The Nurse Licensure Compact's Effect on Telemedicine Usage

As a result of a shortage of primary care physicians, considerable portion of patients in the US have difficulty accessing primary care. Telemedicine allows healthcare professionals to reach patients in shortage areas, but state-based occupational licensing laws make interstate practice difficult. The Nurse Licensure Compact (NLC) was designed to improve interstate practice for Registered Nurses (RNs), including telemedicine. Our preliminary analysis does not find evidence that the NLC is able to significantly increase telemedicine usage from out-of-state providers. Policymakers cannot rely on just the NLC to encourage the adoption of telemedicine; other regulations currently limit its adoption.

Assessment of functionalities and attitude toward telemedicine for patients with cardiovascular disease

Introduction

Many patients with cardiovascular diseases are only seen by a physician once or twice a year unless urgent symptoms. Recent years have shown an increase in digital technologies to follow patients remotely, that is, telemedicine. Telemedicine can be supportive for follow-up of patients at continuous risk. This study investigated patients' attitude toward telemedicine, the defined features they consider important and future willingness to pay.

Methods

Cardiology patients with various types of prior telemedicine follow-up or who never had a telemonitoring follow-up were included. A new self-developed survey was implemented electronically and took 5-10 min to complete.

Results

In total, 231 patients (191 telemedicine [T] and 40 controls [C]), were included. Most participants owned a smartphone (84.8%) and only 2.2% of the total participants did not own any digital device. The most important feature of telemedicine cited in both groups was personalization (i.e., personalized health tips based on medical history, 89.6%; personalized feedback on entered health parameters 86.1%). The most important motivating factor for the use of telemedicine is recommendation by a physician (84.8%), while the reduction of in-person visits is a minor reason (24.7%). Only half of the participants (67.1%) would be willing to pay for telemedicine tools in the future.

Conclusion

Patients with cardiovascular disease have a positive attitude to telemedicine, especially when it allows for more personalized care, and when it is advocated by the physician. Participants expect that telemedicine becomes part of reimbursed care. This calls for interactive tools with proven efficacy and safety, while guarding unequal access to care.

Patient Experience from an eHealth Perspective: A Scoping Review of Approaches and Recent Trends

OBJECTIVES

Patients' experiences are increasingly gaining interest in multiple research fields. Researchers have applied various approaches to studying patient experience (PX); however, there is no commonly agreed-upon definition of PX. This scoping review focuses on PX from an eHealth perspective. Our aim was to: 1) describe how PX has been defined, 2) investigate which factors influencing PX and components of PX have been identified and researched, 3) explore the methods used in studying PX, and 4) find out the recent trends in PX research from an eHealth perspective.

METHODS

We selected six major journals covering the fields of health informatics, PX, and nursing informatics. Using the search terms "patient experience" and technology-related terms (e.g., digital, eHealth), we searched for articles published between 2019 and 2021. From 426 articles, 44 were included in the analysis.

RESULTS

Multiple concepts and meanings are used to refer to PX. Few articles include vague descriptions of the concept. Numerous eHealth factors are influencing PX, as well as components considering PX. The influencing factors were related to eHealth solutions' type and quality, and care process, when the components of PX were related to communication, remote interaction, risks and concerns, and patients' attitudes towards telehealth. Surveys were the main method used to study PX, followed by interviews.

CONCLUSIONS

PX is a complex and multifaceted phenomenon, and it is described as a synonym for patient satisfaction and telehealth experiences. Further multidisciplinary research is needed to understand PX as a phenomenon and to outline a framework for the research.

Factors Impacting Patient Perspectives on Telehealth and Remote Healthcare during COVID-19: A Mixed Methods Study

A rapid transformation to telehealth was a necessary precaution during the pandemic. This research sought a better understanding of factors impacting patients’ decisions on choosing telehealth. A mixed methods study was conducted with a sample of 276 patients. An online survey was used to collect qualitative and quantitative data. This study found that technical issues were the most significant factor preventing patients from using telehealth, among other factors such as waiting time and privacy concern. The results inform policy-makers and healthcare providers on how to optimize telehealth. The limitations of this study and future research directions are also discussed.

Association between state payment parity policies and telehealth usage at community health centers during COVID-19

OBJECTIVE

We study the association between payment parity policies and telehealth utilization at community health centers (CHCs) before, during, and after the onset of the pandemic.

MATERIALS AND METHODS

We use aggregated, de-identified data from FAIR Health for privately insured patients at CHC sites. Descriptive statistics and time trends are calculated. Logistic regression models were used to quantify the factors associated with telehealth utilization for each of our time periods: 1) pre-pandemic (March-June 2019), 2) immediate pandemic response (March-June 2020), and 3) sustained pandemic response (March-June 2021).

RESULTS

Telehealth usage rates at CHC sites surged to approximately 61% in April 2020. By April 2021, only 29% of CHC sites in states without payment parity policies used telehealth versus 42% in states without. Controlling for other characteristics, we find that CHC sites in states with payment parity were more likely to utilize telehealth one year after the onset of the pandemic (OR:1.740, p<0.001) than states without, but did not find this association in 2019 or 2020.

DISCUSSION

The public health emergency drove widespread use of telehealth, making the virtual care environment inherently different in 2021 than in 2019. Due to the unique fiscal constraints facing CHCs, the financial sustainability of telehealth may be highly relevant to the relationship between telehealth utilization and payment parity we find in this paper.

CONCLUSION

Supportive payment policy and continued investments in broadband availability in rural and undeserved communities should enable CHCs to offer telehealth services to populations in these areas.