Telemedicine and the Patient Experience

While telemedicine has been discussed as a solution for seeing patients during the COVID-19 pandemic, little attention is paid to the patient experience of remote visits. This is especially pertinent to telemedicine’s longevity beyond the pandemic and, for that matter, to whether there will be pressure upon payers to reimburse physicians appropriately for their telemedicine visits. Though telemedicine, for obvious reasons, lacks the intimacy that can be achieved with an in-office visit, there is a wealth of evidence to suggest that patients welcome the ability to use telemedicine to connect with their healthcare providers.

Though we tend to think of telemedicine as a recent development, the British Medical Journal published a meta-analysis 20 years ago on the patient experience of telemedicine encounters. This analysis drew from 32 previously published papers on the topic with contexts ranging from specialist consultations to home nursing. They noted that “the patients found teleconsultations acceptable… definite advantages, particularly increased accessibility of specialist expertise, less travel required, and reduced waiting times.”

More recently, there has been an extensive body of evidence showing that patients are equally (or more) satisfied with telemedicine visits as compared to in-office visits. A randomized controlled trial by Cremades et al compared 200 general surgery patients seen via telemedicine to those via conventional visits. The authors found no difference in patient satisfaction and outcome between the two groups. A 2019 randomized study of migraine patients states that patients were more satisfied with telemedicine visits than in-office visits due to decreased travel time and less need to miss work.

Hanson et al (2020) found that pediatric patients with spinal deformities, as well as their parents, were equally satisfied with telemedicine as in-office visits, the former associated with shorter wait times. Similarly, a 2020 paper comparing low-acuity patients seen via telemedicine to those seen in the ER note similar satisfaction levels between the two groups, also noting that the length of “stay” for those seen via telemedicine was about half of the control group (64 minutes vs. 134 minutes) and that 72-hour return visits were similar between the two groups.

Though the articles cited are not a comprehensive review, similar results can be found throughout numerous specialties and conditions, with benefits of telemedicine commonly noted to be reducing disparities in care, decreased commute and wait times and cost savings for patients. This evidence suggests that patients’ experience with telemedicine is positive, at times preferring this approach to in-office visits, and that telemedicine is expected to be a long-term tool within a practice’s armamentarium.

By: Joshua Baron, MD: EHI Subject Matter Expert

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