Telehealth to the Rescue During COVID-19: A Convergent Mixed Methods Study Investigating Patients' Perception

Abstract

Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE).Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis.Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p < 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: “Factors that worked to the benefit of the patients,” “Factors that the patients were not in favor of,” and “Opportunities for improvements as perceived by the patients.”Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.

Patient-reported experiences and outcomes of virtual care during COVID-19: a systematic review

“…In the studies that included qualitative findings, we get an in-depth understanding of the experiences of patients and caregivers with virtual care delivery during COVID-19. For instance, in the study by Al-Sharif et al[ 58 ], they found convenience and safety to be two major advantages to virtual care delivery, especially with the high risk of getting infected with COVID-19. Juarez-Reyes et al[ 59 ] found patient participants expressed gratitude for continued mental health support, and being able to still be a part of virtual group sessions.…”

“…Some studies that used PREMs and also qualitative interviews reported challenges patients and caregivers faced with virtual care, such as feeling rushed during the virtual appointment (2% of PREMs articles) [ 26 , 38 , 48 ], lack of physical contact with the healthcare provider for physical examinations (15% of PREMs articles) [ 21 , 23 , 26 , 35 , 58 , 87 , 88 ], technical challenges (2% of PREMs articles) [ 26 , 29 , 35 , 37 , 43 , 48 , 56 , 77 ], a preference for in-person care delivery (8.5% of PREMs articles) (e.g. due to the lack of personal connection with healthcare provider online) [ 21 , 23 , 28 , 38 , 41 , 54 , 88 , 89 ], and difficulty with communicating symptoms or asking all of their questions (6% of PREMs articles) [ 29 , 87 , 90 ].…”

Assessment of the Practices and Perspectives of Healthcare Providers Towards Utilization of Telemedicine for the Care of Adult Patients With Diabetes Mellitus During the COVID-19 Pandemic in India

“…The effectiveness of telediabetes modality has been proven through multiple studies. In a pre-COVID meta-analysis of 13 randomized controlled trials, telemedicine was associated with a statistically significant and clinically relevant reduction in HbA1c level but did not show such an effect on blood pressure and LDL cholesterol reduction [ 18 ]. In a systematic review of 37 studies to assess physician satisfaction with telemedicine, which included varied types of telemedicine or provider teleconsultation and different diagnoses or care situations, it was shown that physicians across specialties, geographic locations, practice locations, and care situations appear satisfied with telemedicine.…”

Effects of first year COVID-19 pandemic on urology practice in three major Arab Countries: Sub-Analysis of a survey by Arab association of urology research group

“…Most participants (70.0%) believed telemedicine might lower transportation expenses and save time, labour, and costs. In Dubai, Al-Sharif et al [ 16 ] reported high satisfaction levels with telemedicine but identified specific areas for improvement. They found that patients with higher education and those who experienced a shorter duration of teleconsultations were more satisfied, so it is recommended that guidelines define the optimal telemedicine consultation duration.…”