Telemedicine in Otolaryngology During COVID‐19: Patient and Physician Satisfaction

Abstract

Objective To examine patient and physician satisfaction with telemedicine in otolaryngology during COVID-19 and identify associated factors. Study Design Prospective cohort study. Setting Tertiary care center. Methods Patient satisfaction was rated by patients (age ≥18 years) who had encounters from May to July 2020 (n = 407). Physician satisfaction was rated by 15 otolaryngologists for specific encounters delivered from May to June 2020 (n = 1011). Patient satisfaction was measured with a Press Ganey questionnaire and a Telemedicine Satisfaction Questionnaire. Mean Press Ganey satisfaction scores of telemedicine encounters during COVID-19 were compared with the pre−COVID-19 Press Ganey scores from in-person encounters (n = 3059) to test a noninferiority hypothesis. Physician satisfaction was measured with a Provider Satisfaction Questionnaire. Results The mean Press Ganey patient satisfaction score for telemedicine encounters was 94.5 (SD, 8.8), no worse than that for in-person encounters prior to COVID-19 at 93.7 (SD, 15.5; Δ = 0.8 [95% CI, −0.5 to 2.1, excluding the noninferiority margin of −1]). Encounters with videoconference (vs telephone) and patients reporting higher income were associated with higher Telemedicine Satisfaction Questionnaire scores. Physician satisfaction scores during COVID-19 with telemedicine encounters were overall high at 83.3 (95% CI, 77.5-89.1), slightly lower when compared with the scores with in-person encounters at 88.4 (95% CI, 82.5-94.3; Δ = −5.2 [95% CI, −6.6 to −3.8]). Encounters with videoconference (vs telephone) and patients with English as a preferred language and follow-up visits were associated with higher Provider Satisfaction Questionnaire scores. Conclusions Telemedicine is a feasible alternative format in otolaryngology during COVID-19 with overall high patient and physician satisfaction. Patient satisfaction with telemedicine encounters during COVID-19 was no worse than in-person encounters prior to the pandemic. Physician satisfaction with telemedicine was relatively lower in comparison with in-person encounters.

Telemedicine Services Provided to Medicare Beneficiaries by Otolaryngologists in 2020

“…Nonetheless, current evidence on telemedicine implementation within otolaryngology suggests similar quality of care 9 and provider/patient satisfaction, with comparable satisfaction scores to in-person visits. 10 Telemedicine regulation has also evolved during the COVID-19 pandemic, including coverage of audio-only visits, select states eliminating patient cost sharing for telemedicine services, 11 and increased provider reimbursement for telemedicine visits. 12 Emerging evidence suggests that much work is needed to ensure that advances in telemedical care reach vulnerable populations; a recent Centers for Medicare & Medicaid Services study found that Black and rural communities utilize telemedicine the least.…”

Provider and Patient Satisfaction with Telemedicine Voice Therapy During the COVID-19 Pandemic

“…Patients and providers self-reported their level of satisfaction on a visual analog scale (VAS; range 0-100) with end anchors indicating 'not at all satisfied' or 'extremely satisfied'. Patient satisfaction was additionally measured using the Telemedicine Satisfaction Questionnaire (TSQ; range 1-5), a patient-reported outcome measure that has been shown to be both reliable and valid, 32 Used in numerous studies investigating patient satisfaction with telemedicine, 15 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 the TSQ consists of 14 items scored on a 5 point Likert scale and assesses satisfaction across the quality of care provided, similarity to face-to-face encounter, and overall perception of the interaction. Patients also answered two binary questions about (1) their desire to choose telemedicine over in-person therapy in the future and (2) their internet reliability.…”

“…Within the field of otolaryngology, patients report high levels of satisfaction with telemedicine care. 12 , 13 , 14 , 15 A recent study performed at this institution demonstrated high concordance rates in both diagnosis and management between initial telemedicine visit and subsequent laryngoscopy; 16 thus, although laryngoscopy is ultimately needed for definitive diagnosis of vocal pathologies, empiric voice therapy can be offered via telepractice in certain situations until in-person evaluation is safely performed.…”

COVID-19 and the resurgence of telehealth in otolaryngology

“…The attitudes of Otolaryngology patients toward telemedicine are also favorable with a high satisfaction rate. [50][51][52][53] Perceived benefits of telehealth by patients include improved convenience and decreased costs associated with travel and parking. 52 , 54 Higher patient satisfaction has been associated with videoconference visits (vs telephone) and patients with English as a preferred language.…”

“…52 , 54 Higher patient satisfaction has been associated with videoconference visits (vs telephone) and patients with English as a preferred language. 53 There are barriers to telehealth to be aware of, however, which include patient access to technology, access to an interpreter, lack of trained staff, level of patient education, and patient comfort. 52 , 55 , 56 Based on an open-ended survey of Otolaryngology patients who had a video-based telehealth visit, the majority of reservations were centered around internet connection and accessing the user interface.…”