Telehealth versus face-to-face visits: A comprehensive outpatient perspective-based cohort study of patients with kidney disease

Abstract

Background Telenephrology has become an important health care delivery modality during the COVID-19 pandemic. However, little is known about patient perspectives on the quality of care provided via telenephrology compared to face-to-face visits. We aimed to use objective data to study patients’ perspectives on outpatient nephrology care received via telenephrology (phone and video) versus face-to-face visits. Methods We retrospectively studied adults who received care in the outpatient Nephrology & Hypertension division at Mayo Clinic, Rochester, from March to July 2020. We used a standardized survey methodology to evaluate patient satisfaction. The primary outcome was the percent of patients who responded with a score of good (4) or very good (5) on a 5-point Likert scale on survey questions that asked their perspectives on access to their nephrologist, relationship with care provider, their opinions on the telenephrology technology, and their overall assessment of the care received. Wilcoxon rank sum tests and chi-square tests were used as appropriate to compare telenephrology versus face-to-face visits. Results 3,486 of the patient encounters were face-to-face, 808 phone and 317 video visits. 443 patients responded to satisfaction surveys, and 21% of these had telenephrology encounters. Established patients made up 79.6% of telenephrology visits and 60.9% of face-to-face visits. There was no significant difference in patient perceived access to health care, satisfaction with their care provider, or overall quality of care between patients cared for via telenephrology versus face-to-face. Patient satisfaction was also equally high. Conclusions Patient satisfaction was equally high amongst those patients seen face-to-face or via telenephrology.

Racial Disparities in Patient-Provider Communication During Telehealth Visits Versus Face-to-face Visits Among Asian and Native Hawaiian and Other Pacific Islander Patients With Cancer: Cross-sectional Analysis

“…Telehealth also allows health care providers to reach patients and other specialists remotely, allows them to reach larger segments of the population, alleviates workforce shortages in remote areas, and improves care coordination [1][2][3][4][5][6]. Patient satisfaction with telehealth has been well documented, particularly among residents from rural communities [2,4,[6][7][8], with as many as 95% of patients rating telehealth visits as "better than" or "just as good" as face-to-face visits [6,9,10]. Specifically, studies of oncology patients have reported high levels of satisfaction with telehealth [3][4][5]8,[11][12][13][14].…”

Impact of COVID-19 on patient experience of kidney care: a rapid review

“…Majority aged 50–64 years old Feedback questionnaire Remote consultation 88% of patients replied positively about their experience. Significant impact on the overall time saved, as well as convenient [40%] Androga et al [ 16 ] Nephrology Clinic in USA 3361 CKD outpatients (stages 1–5, treatment unspecified) Aged 47–75 years old, predominantly White Patient Satisfaction Survey Not validated Consultation over telephone/ video call There was no difference in patient survey responses for the above when telehealth was compared to face-to-face visits [80%] Antoun et al [ 20 ] HHD and ICHD in UK 20 adult CKD patients (10 ICHD, 10 HHD) 70% male, Aged 52–77 years old Semi-structured telephone interviews Not validated QoL, Wellbeing and PA QoL, Wellbeing, PA and Medical care all impacted ICHD negatively. HHD little change Focus on impact of shielding.…”

“…One study found significant differences in preferences according to the age of the patient, with older patients opting for face-to-face appointments. There were no differences in relation to ethnicity and gender [ 16 ]. A recurring issue with telemedicine was the inability to have physical issues examined by the consulting clinician [ 15 – 17 ].…”

Patient satisfaction with telehealth versus in‐person visits during COVID‐19 at a large, public healthcare system

“…On the one hand, patients may prefer the potential convenience of telehealth visits; on the other hand, patients may be discontented by new barriers related to technology usage or unmet expectations of what can and should be achieved during a medical encounter (e.g., physical examination). Prior studies have suggested that patient satisfaction for telehealth visits may be on par with or better than in‐person visits 5–10 . However, whether this is true in a safety‐net, adult primary care population is not well‐established.…”

“…Prior studies have suggested that patient satisfaction for telehealth visits may be on par with or better than in‐person visits. 5 , 6 , 7 , 8 , 9 , 10 However, whether this is true in a safety‐net, adult primary care population is not well‐established. Additionally, differences in satisfaction between audio‐only and video visits are not well‐described.…”