Telemedicine During COVID‐19 for Outpatient Sports and Musculoskeletal Medicine Physicians

Abstract

Introduction The global pandemic due to SARS‐CoV‐2 has resulted in an expansion of telemedicine. Measures of quality and barriers for rapid use by patients and physicians are not well described. Objective To describe results from a quality improvement initiative during a rapid adoptive phase of telemedicine during the pandemic. Design Patient and physician satisfaction with synchronous audiovisual telemedicine visits was measured during the early adoptive phase (6 April 2020‐17 April 2020) within the division of sports medicine in an academic Physical Medicine and Rehabilitation (PM&R) department. Patients were invited to participate in a quality improvement initiative by completing an online survey at the end of a telemedicine visit. Physicians completed a separate survey. Primary Outcome Measures Patient measures included visit type, duration of encounter, quality, and satisfaction. Physicians reported on experiences performed telemedicine. Results Surveys were completed by 119 patients (293 telemedicine encounters, response rate 40.6%) and 14 physiatrists. Telemedicine was utilized primarily for follow‐up visits (n = 74, 70.6%), and the most common duration was 15 to 29 minutes. Patients rated their telemedicine visit as “excellent” or “very good” across measures (91.6%‐95.0%) including addressing concerns, communication, developing a treatment plan, convenience, and satisfaction. Value of completing a future telemedicine visit was measured at 84.9%. Most reported estimated travel time saved was in excess of 30 minutes. Rate of no‐show was 2.7%. Most physicians (57.1%) had no prior experience with telemedicine visits, and most were comfortable performing these visits after completing 1 to 4 sessions (71%). Nearly all physicians (92.9%) rated their telemedicine experience as very good or excellent. The key barrier identified for telemedicine was technical issues. All physicians reported plans to perform telemedicine visits if reimbursement continues. Conclusions In summary, rapid expansion of telemedicine during the COVID‐19 pandemic was well‐received by a majority of patients and physicians. This suggests feasibility in rapid expansion of telemedicine for other outpatient sports medicine practices.

Satisfaction with the use of telehealth during COVID-19: An integrative review

“… Telemedicine satisfaction levels did not differ by region (MW, NE, S, W satisfaction at 86.2%, 84.1%, 78.8, 76.0%, respectively, p = 0.73). Tenforde et al. (2020) Patient rated telemedicine visit as excellent or very good across measures (91.6–95%) 92.3% of physicians reported excellent or very good overall satisfaction …”

“…23 to April 24, 2020 108 patients completed survey (70 telemedicine and 34 face-to-face); median age 58 years old; 56% females 18 clinicians: (4 consultants, 4 clinical research fellows, 4 residents, 2 nurse specialists, 4 research nurses Royal Mardsen Hospital Sarcoma Unit, UK Patient and provider experience with telemedicine - Questionnaire LOE VI Svider et al. (2020) USA Descriptive survey-based study Rhinology April 2020 135 respondents from four practice regions New Jersey Degree of use; Satisfaction with service – Anonymous Survey LOE VI Tenforde et al. (2020) USA QI Sports & Musculoskeletal Most common duration 15–29 min April 6–17, 2020 Surveys completed by 119 patients and 13 physiatrists.…”

“…(2020) Phone SVIDER ET AL. (2020) Various video platforms including Doxy.me, Zoom, Google Hangouts, Apple Facetime, Skype, Upfox, VSee, Others TENFORDE ET AL. (2020) Synchronous audiovisual telemedicine platforms and included both InTouch and Zoom Legends: F2F – face-to-face.…”

“…Of the five studies that evaluated clinician satisfaction with the use of telehealth, four studies reported high level of satisfaction based on scores of 80% and above ( Dobrussion et al., 2020 ; Rametta et al., 2020 ; Svider et al., 2020 ; Telforde et al., 2020 ), whereas one study reported healthcare provider's satisfaction score of 78 out of 100 ( Gilbert et al., 2020 ). Several studies noted that patients and healthcare providers were willing to continue to use telehealth as part of their follow-up visits even after the COVID-19 pandemic ( Dobrussin et al., 2020 ; Holtz et al., 2020 ; Li et al., 2020 ; Rametta et al., 2020 ).…”

Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine

“…2 Physiatric telemedicine was already in place at our institution, but required rapid expansion and was met with high satisfaction. 3 In contrast, telerehabilitation was new to the system.…”