No pelvic exam, no problem: patient satisfaction following the integration of comprehensive urogynecology telemedicine

Abstract

Introduction and hypothesisThe COVID-19 pandemic revolutionized the practice of medicine, requiring rapid adoption of telemedicine. However, patient satisfaction has not been well characterized for telemedicine visits for a broad range of urogynecologic conditions. Methods We performed a cross-sectional survey study following a retrospective review of all urogynecologic telemedicine visits from March 1, 2020, to March 31, 2021, at a tertiary care center. The survey queried patient satisfaction using the Likert scale. Descriptive statistics and Fisher's exact analyses were performed. Results There were 256 telemedicine visits at our institution during the study period, and 88 patients (34% unadjusted response rate) completed the survey. The average age of study participants was 55 (SD 17; 24, 84) years old. The majority of patients were white (69%), lived within the five boroughs of NYC (81%), and had higher levels of education (72% with a bachelor's or professional degree). Most visits were for urinary complaints (68%), with those patients reporting greater fulfillment of urogynecologic needs compared to patients presenting with pelvic complaints (p = 0.02). There were no significant differences in satisfaction among other demographics (p > 0.05). Altogether, high satisfaction rates were noted for scheduling (99%), technology (90%), provider interaction (96%), fulfillment of personal needs (91%), and overall satisfaction (94%). Conclusions We demonstrate high patient satisfaction for telemedicine visits in a tertiary urogynecology clinic for a variety of indications, with greater fulfillment of urogynecologic needs observed for those visits which may not necessitate an inperson exam (e.g., urinary complaint).

Patient Satisfaction With Telehealth Visits for New Patient Appointments for Pelvic Floor Disorders: A Randomized Trial of Telehealth Versus Standard In-Person Office Visits

“…11 Another study of 88 patients found high satisfaction of 94% with telehealth. 5 The two latter studies included new and returning patients. Although we were unable to demonstrate noninferiority, our findings provide supportive evidence of high patient satisfaction with telehealth for new visits.…”

“…Until recently, telehealth was used to reach patients with limited access to care, remotely monitor chronic medical conditions, and follow-up on hospital discharges. 2,4,5 In obstetrics and gynecology, telehealth has been used for the management of obstetric conditions, treatment and follow-up of family planning services, and the provision of perioperative care. 1 Data from other surgical subspecialties have further supported the use of telehealth for perioperative care.…”

“…Although the acceptability and safety of telehealth have been reported in urogynecology for perioperative care, the use of telehealth for new patient visits has not been well studied. Although a few cross-sectional studies have reported promising outcomes, 5,11 there are limited data on patient satisfaction with telehealth when seeking care with a health care provider for the first time.…”

“…Studies comparing telehealth to traditional care have found comparable health outcomes, patient satisfaction, and patient engagement 1,3 . Until recently, telehealth was used to reach patients with limited access to care, remotely monitor chronic medical conditions, and follow-up on hospital discharges 2,4,5 …”

Nonsurgical treatments for patients with urinary incontinence

“…7 During the COVID-19 pandemic, abbreviated, virtual assessments for urinary symptoms were associated with high degrees of satisfaction (91% for fulfillment of personal needs, 94% overall satisfaction). 8 This highlights the value of validated symptom questionnaires that help establish a working diagnosis and treatment plan in the absence of a physical exam. Questionnaire-based diagnoses have acceptable accuracy for classifying UUI and SUI among women with uncomplicated medical and surgical histories and for initiating low-risk therapies for defined intervals.…”