Patient Perceptions of Telehealth Primary Care Video Visits

Abstract

PURPOSE Telehealth is a care delivery model that promises to increase the flexibility and reach of health services. Our objective is to describe patient experiences with video visits performed with their established primary care clinicians. METHODSWe constructed semistructured, in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center. Data were analyzed with a content analysis approach. RESULTS:Of 32 eligible patients, 19 were successfully interviewed. All patients reported overall satisfaction with video visits, with the majority interested in continuing to use video visits as an alternative to in-person visits. The primary benefits cited were convenience and decreased costs. Some patients felt more comfortable with video visits than office visits and expressed a preference for receiving future serious news via video visit, because they could be in their own supportive environment. Primary concerns with video visits were privacy, including the potential for work colleagues to overhear conversations, and questions about the ability of the clinician to perform an adequate physical examination.CONCLUSIONS Primary care video visits are acceptable in a variety of situations. Patients identified convenience, efficiency, communication, privacy, and comfort as domains that are potentially important to consider when assessing video visits vs in-person encounters. Future studies should explore which patients and conditions are best suited for video visits. INTRODUCTIONT elemedicine, or telehealth, includes telecommunication via a variety of platforms designed to enhance patient-centered health care.1-3 Telehealth in its many forms offers conveniences including increased care accessibility, decreased transportation barriers, and patient empowerment. [4][5][6][7][8] Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care. [9][10][11][12][13][14][15] One study of patient experiences with video visits in rural areas found that they were associated with decreased travel costs and lost time/wages, increased access to social support, and better ability to tailor care delivery to patient and family needs. 16Because of these benefits, video visits are being adopted in a variety of settings. Uptake in the United States has occurred most rapidly where reimbursement is favorable. Medicare reimburses for video visits in health professional shortage areas and for specific approved services.17 As a result, much knowledge about patient experiences with video visits is limited to specific disease-related applications and to use in rural settings. [18][19][20] Video visits are increasingly used in other settings, including primary care, but there are limited data on patient experiences with primary care video visits. One study tested video visits with patients communicating via webcam with their primary care physician w...

Exploring patients' and clinicians' experiences of video consultations in primary care: a systematic scoping review

“…38 Five studies used VC as a study intervention. [36][37][38][39][40] In all of these, VC was conducted via a conferencing platform on a smartphone, webcam, or tablet, synchronously between a patient and a clinician. Of these five, one study was a randomised control trial.…”

“…40 Three studies were quantitative descriptive studies [36][37][38] and one was a qualitative interview study. 39 Two studies 11,20 asked patients and/or clinicians about their perceptions of their use of VCs in a primary care setting where this was already available and both were qualitative study designs. 20,23 See Table 1 for study details.…”

“…Convenience and improved access were identified as patient perceived benefits of VCs. 20,38,39 Three studies, all set in the US, showed that patients had chosen VCs in certain circumstances; that is, to reduce travel costs or to minimise time waiting for an appointment or for certain types of condition. [38][39][40] satisfaction with Vc as a medium for consultation…”

“…37 In an interview study, patients reported that they felt able to establish a rapport with their clinician. 39 A randomised control trial comparing video with routine visits reported that patients were more satisfied overall with face-to-face consultations when assessed using a Likert scale (1 = poor, 5 = excellent)(4.6-4.3, P<0.0001) and that patients with chronic conditions were more likely to prefer a face-to-face consultation, this was reported by the authors as a significant P value for the difference between groups (P = 0.01). 40 This matched the findings from a UK qualitative study, which found that patients regarded a face-to-face consultation as the 'gold standard'.…”

“…20 Patients reported difficulties in finding private places to conduct a VC, and this potentially affected the ability to share sensitive information. 39 Technological issues, such as time lag in images and audio, connections and password logins, hindered fluidity in consultation for some patients. 39…”