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Oganov AC, Chou TY, Hanson PM, Abazari A, Kung P, Weissbart SB, Lenoci JN, Honkanen RA. Telemedicine at a University Ophthalmology Practice During the Beginning of the COVID-19 Pandemic. Clin Ophthalmol 2024; 18:2369-2380. [PMID: 39193320 PMCID: PMC11348924 DOI: 10.2147/opth.s460454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 08/07/2024] [Indexed: 08/29/2024] Open
Abstract
Purpose The aim of the research was to evaluate the use of teleophthalmology at a university practice during the COVID-19 pandemic, specifically examining precision, effectiveness, and patient satisfaction. Patients and Methods Telemedicine visits were offered to new and established patients requesting appointments with the Stony Brook University Department of Ophthalmology between March 30 and June 2, 2020. Records from these visits were reviewed for chief complaint, past medical and ocular history, diagnoses, treatment/management, and providers' sub-specialty. Precision was determined by comparing agreement between diagnoses of the telemedicine visit with those of the subsequent in-person visit. The decision to follow up in person was made by the physician and patient. Diagnostic precision as well as progression, improvement, or stability of patients' symptoms were determined by the physician's assessment at follow-up visits. Post-telemedicine visit satisfaction surveys were sent to all patients. Results Telemedicine visits were offered to 783 patients, 520 (66.4%) of whom accepted. Of these 520 patients, 409 (78.7%) were established and 105 (20.2%) had in-person, follow-up visits. Overall, the diagnostic precision of the follow-up visits was 89.5%. Precision differed significantly across ophthalmologic subspecialties. Of the patients who had in-person follow-up visits, 56.8% remained stable, 32.4% improved, and 10.8% worsened. Established patients presented with more extensive ocular histories/procedures and experienced a higher percentage of worsening symptoms/disease stage compared to new patients. Oculoplastics/orbit was the most prevalent diagnostic subspecialty that worsened. Surveys were sent to all patients completing telemedicine visits, 15.0% of whom responded. Overall satisfaction was 91.9%, although only 23.0% of respondents preferred telemedicine to an in-office visit. Conclusion Telehealth provides high levels of precision and patient satisfaction for a wide range of ophthalmologic visits, although most patients still prefer in-office examinations. Employing teleophthalmology for follow-up and emergency care may provide patients with an effective alternative during pandemic situations and beyond.
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Affiliation(s)
- Anthony C Oganov
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Timothy Y Chou
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Paris M Hanson
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Azin Abazari
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Preston Kung
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Sarah B Weissbart
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Jacqueline N Lenoci
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
| | - Robert A Honkanen
- Department of Ophthalmology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11974, USA
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Vinadé Chagas ME, Cristina Jacovas V, de Campos Moreira T, Rodrigues Moleda Constant HM, Fernanda Rohden S, Stiehl Alves S, Santini F, Dall'Agnol S, König Klever E, Cezar Cabral F, da Silva Terres M. Are We Adequately Measuring Patient Satisfaction with Telemedicine? A Systematic Review with a Meta-Analysis. Telemed J E Health 2024; 30:1522-1538. [PMID: 38436274 DOI: 10.1089/tmj.2023.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Introduction: Telemedicine has gained significant attention as an effective means of providing health care remotely, particularly during the COVID-19 pandemic. Patient satisfaction is a critical aspect of implementing telemedicine, but we have no comprehensive understanding of satisfaction levels and the associated factors. The aim of this systematic review and meta-analysis was to assess patient satisfaction related to telemedicine consultations and to identify key factors influencing satisfaction levels. Results: The search yielded a total of 147 cross-sectional studies, of which 107 met the criteria for inclusion in the meta-analysis. Overall, patient satisfaction with teleconsultations was found to be high, with satisfaction levels ranging from 38 to 100 on a scale of 0 to 100. Only a small percentage (2.72%) of the studies reported satisfaction levels below 75%. Surprisingly, most studies used nonvalidated satisfaction questionnaires, which highlight the need for the development of standardized measurement instruments. Conclusions: This systematic review and meta-analysis provide evidence that patients generally exhibit high levels of satisfaction with telemedicine consultations. The use of nonvalidated satisfaction questionnaires in many studies, however, suggests a need for more standardized assessment tools. Factors such as the time interval between the consultation and the assessment were found to influence satisfaction levels. Understanding these factors can help health care providers improve telemedicine services and patient-provider relationships and optimize health care delivery in the context of telemedicine. Further research is warranted to develop validated satisfaction measurement instruments and explore any additional factors that influence patient satisfaction with telemedicine.
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Affiliation(s)
- Maria Eulália Vinadé Chagas
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Suelen Stiehl Alves
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Santini
- Universidade do Vale do Rio dos Sinos (Unisinos), Business School, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sara Dall'Agnol
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Emanuele König Klever
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Mellina da Silva Terres
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Alasiri AA, Alotaibi SA, Schussler E. Patient satisfaction among Saudi academic hospitals: a systematic review. BMJ Open 2024; 14:e081185. [PMID: 38772587 PMCID: PMC11110550 DOI: 10.1136/bmjopen-2023-081185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/27/2024] [Indexed: 05/23/2024] Open
Abstract
PURPOSE To systematically review the patient's satisfaction (PS) levels within academic hospitals in Saudi Arabia from January 2012 to the end of October 2022. DATA SOURCES Articles were gathered from PubMed, ProQuest, Google Scholar and Web of Science. STUDY SELECTION/DATA EXTRACTION This review identified studies that assessed PS in Saudi Arabian university hospitals. Articles published before January 2012, as well as commentary letters, conference papers, theses and dissertations, were excluded. The study employed the five domains of PS as outlined by Boquiren et al. Two independent reviewers independently identified qualifying studies, used the Joanna Briggs Institute tools to evaluate the quality of each study and extracted essential data from each article. RESULTS Out of the 327 studies identified during the search phase, 11 met the project's objectives and criteria. Six studies reported overall PS rates ranging from 78% to 95.2%, with only one study indicating lower PS levels in emergency departments. Most studies demonstrated that technical skill is the primary domain influencing PS in academic hospitals. CONCLUSION There is a need for further investigation to explore the factors influencing PS using standardised survey instruments suitable for Saudi culture. Contradictory results regarding PS are clearly evident in the literature; therefore, it is advisable to standardise the assessment process to reduce discrepancies within the academic hospital setting in Saudi Arabia.
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Affiliation(s)
- Ahmed Ali Alasiri
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
- Health Services Research,College of Health Sciences, Old Dominion University, Norfolk, VA, USA
| | - Saad A Alotaibi
- Department of Public Health,College of Applied Medical Sciences, Qassim University, Buraydah 51452 P.O. Box 6666, Saudi Arabia
| | - Eric Schussler
- Rehabilitation Sciences, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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Chang HC, Wang LU, Chiou HY, Chen RC, Chen HF, Yao CW, Liu SL, Chen KC, Liao YT, Lin TC, Chuang WP, Wang JK. Impact of Telemedicine on Blood Glucose Control and Ophthalmic Screenings for Patients with Diabetes in Remote Areas During the COVID-19 Pandemic: A Real-World Study in Northern Taiwan. Telemed J E Health 2024. [PMID: 38739447 DOI: 10.1089/tmj.2024.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2024] Open
Abstract
Introduction: The purpose of this study was to assess the impact of telemedicine on ophthalmic screening and blood glucose control for patients with diabetes in remote areas of Northern Taiwan during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Telemedicine was implemented in Shiding and Wanli Districts using a 5G platform from April 2021 to December 2022. Patients with poorly controlled diabetes received real-time consultations from endocrinologists at Far Eastern Memorial Hospital, 50 km away, for medication adjustment, diet control, and lifestyle recommendations. The study also provided cloud-upload blood glucose meters for self-monitoring and regular medical advice from hospital nurses. Ophthalmic screenings included fundus imaging, external eye image, and intraocular pressure measurement, with instant communication and diagnosis by ophthalmologists through telemedicine. A satisfaction questionnaire survey was conducted. Results: The study enrolled 196 patients with diabetes. Blood glucose and glycosylated hemoglobin levels were significantly reduced after applying telemedicine (p = 0.01 and p = 0.005, respectively). Ophthalmic screenings led to hospital referrals for 16.0% with abnormal fundus images, 15.6% with severe cataract or anterior segment disorders, and 27.9% with ocular hypertension or glaucoma. Fundus screening rates remained high at 86.3% and 80.4% in 2022, mainly using telemedicine, comparable with the traditional screening rate in the past 5 years. The overall satisfaction rate was 98.5%. Conclusions: Telemedicine showed effectiveness and high satisfaction in managing diabetes and conducting ophthalmic screenings in remote areas during the COVID-19 pandemic. It facilitated early diagnosis and treatment of ocular conditions while maintaining good blood glucose control and fundus screening rates.
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Affiliation(s)
- Hao-Chun Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ling-Uei Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institute, Zhunan, Taiwan
| | - Ran-Chou Chen
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Hua-Fen Chen
- Department of Endocrinology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chih-Wei Yao
- Shiding District Health Center, Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Shang-Lin Liu
- Wanli District Health Center, Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Kuo-Cheng Chen
- Far EasTone Telecommunications Co., Ltd., Taipei City, Taiwan
| | - Yu-Ting Liao
- Institute of Population Health Sciences, National Health Research Institute, Zhunan, Taiwan
- Center for Community Health Development, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tzu-Chun Lin
- Center for Community Health Development, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wen-Po Chuang
- Center for Community Health Development, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
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Sung YC, Sheu SJ, Hsu SL. Feasibility Analysis of Teleophthalmology Diagnosis and Referral in Remote Areas of Taiwan. Telemed J E Health 2023; 29:1523-1529. [PMID: 37022780 DOI: 10.1089/tmj.2022.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Background: Remote areas of Taiwan lack routine and specialized ophthalmology services. This study aimed to analyze feasibility of teleophthalmology service for diseases diagnosis and referral in remote areas of Taiwan. Methods: A retrospective study of medical records from 11 remote teleophthalmology clinics in the Taitung area of Taiwan was conducted from May 2020 to December 2021. Vision and intraocular pressure were checked. Ophthalmic imaging was performed by local trained nurses using a hand-held ophthalmoscope and slit lamp biomicroscope. The images were transmitted by telemedicine system to a medical center. Consultation was conducted via face-to-face real-time video calls. Ophthalmologists in the medical center provided diagnosis and treatment advice based on the real-time images and interactive history taking via the telemedicine system. All the images and data were collected and well-reviewed by ophthalmologists in the medical center, and disease prevalence and referral were analyzed for the program. A small-scale satisfaction questionnaire survey was conducted for efficacy evaluation of the program. Results: A total of 1,401 medical records from 1,094 patients were collected and screened. Patients' ages ranged from 9 months to 94 years, with a mean age of 57.27 (standard deviation ±20.47) years. The most frequent ophthalmologic diagnosis was dry eye disease (20.2%), followed by conjunctivitis (12.4%). Among 322 patients with underlying diseases of diabetes mellitus, 59 patients (18.3%) were diagnosed with diabetic retinopathy. Major diagnosis was made in 102 patients (7.3%) and referral to hospital for further management was suggested. This program had high overall satisfaction score of 89% (mean 4.43 ± 0.52 points) in satisfaction questionnaire survey. Conclusion: Teleophthalmology provides an alternative tool for ocular disease diagnosis and screening for patients in remote areas, especially during the COVID-19 pandemic. This service helps to detect major but undiagnosed diseases and promotes health care accessibility and availability in remote areas that lack specialists.
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Affiliation(s)
- Yu-Chi Sung
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shwu-Jiuan Sheu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shiuh-Liang Hsu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Raj M, Rai P, G V L N, Onkar A, Angral S, Varshney S. Feasibility and Acceptability of Teleconsultation During COVID-19: A Cross-Sectional Study. Cureus 2022; 14:e30937. [PMID: 36465724 PMCID: PMC9711946 DOI: 10.7759/cureus.30937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 06/17/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic created an aberrant challenge for healthcare delivery systems, forcing public health policies across the globe to be shifted from traditional medical care in hospitals to virtual care in the homes of patients. To tackle this pandemic, telemedicine had taken center stage. This study aims to learn about patient satisfaction, feasibility, and acceptability of the use of telemedicine for clinical encounters during the COVID-19 pandemic. Methodology This single-center, cross-sectional, observational study was done on a total of 758 patients who were provided with teleconsultations during the COVID-19 pandemic. We developed a 49-item questionnaire consisting of patients' quality of consultation and patients' expectations to evaluate the feasibility, acceptability, and patient satisfaction with their telemedicine consultations. Results The majority of survey participants (97.1%) expressed satisfaction with the quality of the consultations provided through telemedicine. A large percentage of participants (96.8%) reported the benefits of teleconsultation in treating their problems. Overall, 93.3% of participants responded positively to the continuation of teleconsultation services after the pandemic. Conclusions The study revealed a wide extent of satisfaction among patients. The feasibility and acceptability of telemedicine services have transformed the mode of healthcare delivery systems.
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Affiliation(s)
- Manish Raj
- Department of Orthopaedics, All India Institute of Medical Sciences, Deoghar, IND
| | - Priyanka Rai
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Deoghar, IND
| | - Narasimha G V L
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, IND
| | - Abhishek Onkar
- Department of Ophthalmology, All India Institute of Medical Sciences, Deoghar, IND
| | - Sumeet Angral
- Department of Otolaryngology, All India Institute of Medical Sciences, Deoghar, IND
| | - Saurabh Varshney
- Department of Otolaryngology, All India Institute of Medical Sciences, Deoghar, IND
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Chawla S, Chawla A, Chawla R, Jaggi S, Singh D, Trehan S. Trained nurse–operated teleophthalmology screening approach as a cost-effective tool for diabetic retinopathy. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-021-01037-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Abdel Nasser A, Mohammed Alzahrani R, Aziz Fellah C, Muwafak Jreash D, Talea A Almuwallad N, Salem A Bakulka D, Abdel Ra'oof Abed R. Measuring the Patients' Satisfaction About Telemedicine Used in Saudi Arabia During COVID-19 Pandemic. Cureus 2021; 13:e13382. [PMID: 33754105 PMCID: PMC7972323 DOI: 10.7759/cureus.13382] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/22/2022] Open
Abstract
Background Many studies have found that telemedicine and telehealth services quality and patients' clinical outcomes, following telehealth visits, maybe comparable to those of traditional face-to-face office visits especially in a crisis like COVID-19 complete lockdown. Objective This study aimed to identify the patient's experience in using the telemedicine strategies during the COVID-19 pandemic and assess these patients' perception about their experience of using telemedicine in Saudi Arabia. Methods A cross-sectional survey study was done on 425 patients treated through telemedicine programs in Saudi Arabia from February to August 2020 during the COVID-19 pandemic in Saudi Arabia. An online questionnaire was adopted and modified to elicit participants' socio-demographic data, participants' satisfaction and attitude toward telehealth and telemedicine, and their views on health care services. Results About 84.9% of the participants thought that telemedicine made healthcare easier during the COVID-19 pandemic. Almost half of the respondent was very satisfied with the ease of registration (52%), while 43.4% of respondents stated that they had the ability to talk freely over telemedicine. In the present study, The highest satisfaction was reported by 53.4% of respondents for ease registration, 40.1% for quality of the visual image, 41.9% for quality of the audio sound, and 44.8% for their ability to talk freely over telemedicine, respectively. The highest satisfaction was reported by 40.5% about the ability to understand the recommendations, 40.5% about the overall quality of care provided, 37.4% about the overall telemedicine consult experience. The results revealed a significant positive correlation between satisfaction and attitude scores. Conclusion This study revealed acceptable satisfaction and attitude of patients toward telemedicine programs in Saudi Arabia. However, more effort should be done by the Saudi Ministry of Health to increase the knowledge of patients about teleconsultation available services.
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Affiliation(s)
- Asmaa Abdel Nasser
- Medical Education Department, Faculty of Medicine, Suez Canal University, Ismailia, EGY
- Medical Education Unit, Ibn Sina National College for Medical Studies, Jeddah, SAU
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