Author: Kaitlyn D’Onofrio
The use of telemedicine has surged amid the COVID-19 pandemic, and it is likely to continue beyond the pandemic. It is important to understand how patients feel about telemedicine, and a full understanding cannot be ascertained through questionnaires. The subject of telemedicine and its perception among head and neck cancer patients was the topic of a recent study.
“The implementation of telemedicine is in general a disruptive process for both the physician and the patient. Throughout this transition, patient satisfaction is an important health care quality metric to study,” the researchers wrote. “While [surveys] are important to capture overall attitudes and information regarding the feasibility of video-based telemedicine visits, survey ranking systems do not capture the nuances of the patient experience.”
The present study included established patients who participated in video-based visits with an otolaryngology-head and neck surgery faculty member between March 25 and April 24. In addition to complete a patient satisfaction questionnaire (Telehealth Usability Questionnaire [TUQ]), patients took part in an unstructured telephone interview focused on their perceptions of telemedicine during the COVID-19 pandemic. Charts were retrospectively reviewed to collect patients’ demographic, disease, and treatment information.
Telemedicine: Good for Accessibility, Most Useful for Established Patients
A total of 100 patients completed the TUQ, and 56 also provided open-ended comments. The mean patient age was 61 years, and most patients (60.7%) were male. About a quarter of patients (n=13) talked about their experience leading up to the telemedicine visit; themes that emerged included anxiety and skepticism.
On the technical side, most patients said connecting was easy, although a few had connectivity and audio issues. Sixteen patients needed help from a family or caregiver.
Just over half of patients (n=29) talked about the doctor-patient relationship. Some patients said that having an established relationship with the doctor was important; others said that the use of video “added to the credibility of the visit.”
About a third of patients (n=18) talked about how the COVID-19 pandemic has affected their feelings on telemedicine. They expressed relief that they had an option that allowed them to communicate with their doctors, and said that telemedicine increased accessibility while not increasing their risk of exposure. It also eliminated barriers to care including “transportation and traffic, overall time required to see the doctor, the cost of gas and parking, and associated anxiety.”
Just under half of patients (n=25) talked about future use; emergent themes included: “the use of telemedicine for triage, patient preferences for in-person versus telemedicine visits, the appropriateness of telemedicine, and a desire for a patient-centered decision to conduct a telemedicine visit.” Again, the patients emphasized that ideally, telemedicine would be used in the case of an established doctor-patient relationship but were not sure how effective it would be for a new patient.
The study was published in Otolaryngology–Head and Neck Surgery.
“Patients identified convenience and cost savings as the primary benefits of telemedicine. Primary concerns included the ability to perform a physical examination. Patients held differing opinions of future use, with many noting they would find it acceptable but only if both patients and providers agree on the appropriateness of telemedicine or in extenuating circumstances, such as the current COVID-19 pandemic,” the researchers summarized.