Satisfaction can co-exist with hesitation: qualitative analysis of acceptability of telemedicine among multi-lingual patients in a safety-net healthcare system during the COVID-19 pandemic

Abstract

Background The COVID-19 pandemic triggered unprecedented expansion of outpatient telemedicine in the United States in all types of health systems, including safety-net health systems. These systems generally serve low-income, racially/ethnically/linguistically diverse patients, many of whom face barriers to digital health access. These patients’ perspectives are vital to inform ongoing, equitable implementation efforts. Methods Twenty-five semi-structured interviews exploring a theoretical framework of technology acceptability were conducted from March through July 2020. Participants had preferred languages of English, Spanish, or Cantonese and were recruited from three clinics (general medicine, obstetrics, and pulmonary) within the San Francisco Health Network. Both deductive and inductive coding were performed. In a secondary analysis, qualitative data were merged with survey data to relate perspectives to demographic factors and technology access/use. Results Participants were diverse with respect to language (52% non-English-speaking), age (range 23-71), race/ethnicity (24% Asian, 20% Black, 44% Hispanic/Latinx, 12% White), & smartphone use (80% daily, 20% weekly or less). All but 2 had a recent telemedicine visit (83% telephone). Qualitative results revealed that most participants felt telemedicine visits fulfilled their medical needs, were convenient, and were satisfied with their telemedicine care. However, most still preferred in-person visits, expressing concern that tele-visits relied on patients’ abilities to access telemedicine, as well as monitor and manage their own health without in-person physical evaluation. Conclusions High satisfaction with telemedicine can co-exist with patient-expressed hesitations surrounding the perceived effectiveness, self-efficacy, and digital access barriers associated with a new model of care. More research is needed to guide how healthcare systems and clinicians make decisions and communicate about visit modalities to support high-quality care that responds to patients’ needs and circumstances.

Implementation, Patient Satisfaction and Usability of Telemedicine Services for Pediatric Thalassemia Cases in Balochistan During COVID-19 Pandemic and Beyond

“…Our findings match the results shown by Kaur et Al., who showed that respondents expressed 84-100% agreement to telemedicine health service provided for management of hyperthyroidism [16]. Similarly other researchers also have shown high satisfaction of patients who used telemedicine health service during pandemic [17][18][19].…”

Trends in Use of Telehealth for Behavioral Health Care During the COVID-19 Pandemic: Considerations for Payers and Employers

“…Pre-COVID-19 concerns about acceptability of this modality of health care delivery appear to be somewhat allayed. 15,16 Previous barriers Telehealth service rendered via asynchronous telecommunications system GT Telehealth service rendered via interactive audio and video telecommunication systems related to the comfort of patients or providers with mental health care delivery through telehealth in particular may have been overcome during this pandemic-initiated system change. 1,14 The ability of telehealth services for mental health conditions to fit flexibly and easily into busy lives may have an impact on staying power.…”

Knowing Well, Being Well: well-being born of understanding: Supporting Workforce Mental Health During the Pandemic

“…Pre-COVID-19 concerns about acceptability of this modality of health care delivery appear to be somewhat allayed. 15,16 Previous barriers related to the comfort of patients or providers with mental health care delivery through telehealth in particular may have been overcome during this pandemic-initiated system change. 1,14 The ability of telehealth services for mental health conditions to fit flexibly and easily into busy lives may have an impact on staying power.…”