The Successes and Challenges of Implementing Telehealth for Diverse Patient Populations Requiring Prenatal Care During COVID-19: Qualitative Study

Abstract

Background Although telehealth appears to have been accepted among some obstetric populations before the COVID-19 pandemic, patients’ receptivity and experience with the rapid conversion of this mode of health care delivery are unknown. Objective In this study, we examine patients' prenatal care needs, preferences, and experiences during the COVID-19 pandemic, with the aim of supporting the development of successful models to serve the needs of pregnant patients, obstetric providers, and health care systems during this time. Methods This study involved qualitative methods to explore pregnant patients’ experiences with prenatal health care delivery at the onset of the COVID-19 pandemic. We conducted in-depth interviews with pregnant patients in the first and second trimester of pregnancy who received prenatal care in Cleveland, Ohio, from May to July 2020. An interview guide was used to probe experiences with health care delivery as it rapidly evolved at the onset of the pandemic. Results Although advantages of telehealth were noted, there were several concerns noted with the broad implementation of telehealth for prenatal care during the pandemic. This included concerns about monitoring the pregnancy at home; the need for additional reassurance for the pregnancy, given the uncertainties presented by the pandemic; and the ability to have effective patient-provider discussions via a telehealth visit. The need to tailor telehealth to prenatal health care delivery was noted. Conclusions Although previous studies have demonstrated that telehealth is a flexible and convenient alternative for some prenatal appointments, our study suggests that there may be specific needs and concerns among the diverse patient groups using this modality during the pandemic. More research is needed to understand patients' experiences with telehealth during the pandemic and develop approaches that are responsive to the needs and preferences of patients.

Virtual consultation (VC) in fertility and obstetrics and gynaecology services: An analysis of patient and clinician satisfaction

“…Other studies 8,14,19 have found that clinicians also commonly experienced difficulty with Internet connection, including audio and video issues 4 as was also found in this study. Clinicians in a different study felt that poor Internet connection for either party made the VC time-consuming and ineffective, 14 indicating the need for reliable Internet connection for VC to work in the best way possible.…”

“…Existing studies do not look into patient and clinician satisfaction with the use of VC in fertility and obstetrics and O&G services in the United Kingdom. However, several O&G VC satisfaction studies exist across the globe, [4][5][6][7][8][9][10][11][12][13][14][15][16] and centres in the United States have analysed patient and clinician satisfaction with the use of VC in the field of reproductive endocrinology and infertility. 17,18 These studies have reported high satisfaction rates associated with the use of VC, with improving convenience, 8,14,19 saving time 8,[14][15][16]18 and improving access to care 14,15,18,19 being some common benefits reported by the patients.…”

“…However, several O&G VC satisfaction studies exist across the globe, [4][5][6][7][8][9][10][11][12][13][14][15][16] and centres in the United States have analysed patient and clinician satisfaction with the use of VC in the field of reproductive endocrinology and infertility. 17,18 These studies have reported high satisfaction rates associated with the use of VC, with improving convenience, 8,14,19 saving time 8,[14][15][16]18 and improving access to care 14,15,18,19 being some common benefits reported by the patients. Similarly, some studies show that professionals agree that VC improves patients' access to healthcare.…”

Promoção Da Saúde Da Mulher

“…A respeito dos resultados da teleassistência, a maioria dos artigos relatou que os pacientes sentiram-se satisfeitos; incluindo gestantes de alto risco (JENAGATHAN et al, 2020). Essa satisfação foi relacionada à facilidade da consulta, segurança e diminuição de barreiras como o transporte e o risco de infecção para poder ter acesso ao cuidado (JENAGATHAN et al, 2020, MORGAN et al, 2022, FARRELL et al, 2022, CHEN et al, 2020. Também foi descrita a eficácia da telessaúde na prevenção de desfechos materno-fetais negativos, como restrição do crescimento fetal, diabetes gestacional e pré-eclâmpsia (PALMER et al, 2021), depressão perinatal (LATENDRESSE et al, 2021); GAO et al, (2022) inclusive revelaram que os resultados obstétricos não tiveram diferenças significativas entre os pré-natais realizados de forma presencial e remota.…”

“…Também foi descrita a eficácia da telessaúde na prevenção de desfechos materno-fetais negativos, como restrição do crescimento fetal, diabetes gestacional e pré-eclâmpsia (PALMER et al, 2021), depressão perinatal (LATENDRESSE et al, 2021); GAO et al, (2022) inclusive revelaram que os resultados obstétricos não tiveram diferenças significativas entre os pré-natais realizados de forma presencial e remota. As dificuldades relatadas foram principalmente devidas a dificuldades de acesso (MADDEN et al, 2020;FARRELL et al, 2022) e a uma relativa insegurança entre as gestantes comparado ao modelo presencial (MORGAN et al, 2022).…”