Necessity Is the Mother of Implementation: Patient Satisfaction with Telemedicine for Palliative Care During the COVID-19 Pandemic

Abstract

Outcomes1. Assess patient satisfaction with telemedicine for outpatient palliative care2. Quantify time and resources saved by telemedicine3. Examine patient demographic data and how they correlate to patient satisfaction with telehealth for outpatient palliative careBackgroundCurrent literature on telemedicine use for palliative medicine focuses primarily on the accessibility of virtual health platforms. Information about patients’ attitudes toward using this medium is limited. Telemedicine expansion during the COVID-19 pandemic provided an opportunity to fill this knowledge gap.Aim StatementThe aim of this article is to appraise the value of telemedicine for palliative outpatient care and help guide policy regarding telehealth implementation and expansion.MethodsData are presented from a cross-sectional qualitative survey conducted via telephone of 51 patients who participated in 199 telemedicine visits (mean 3.9 visits per patient) from March through December 2020 during the COVID-19 pandemic. Appointments were for established patients at both a large academic palliative clinic and a safety-net, palliative clinic. Questions measured patient satisfaction with healthcare delivery modes, barriers to care, and technological preparedness.ResultsPrimary: All patients (100%) were either “extremely” or “somewhat” satisfied with their symptom management conducted via telemedicine. A majority of patients (65%) preferred a hybrid model with both telemedicine and in-person visits, and 14% preferred all follow-up via telehealth. Secondary: Telemedicine appointments required less time, travel, and family resources. Combined wait and appointment time for virtual visits was less than 30 minutes for 74% of patients, compared with 65% of patients spending 1 hour or more on in-person clinic days. Over half (56%) of support persons missed work to attend visits. No difference in satisfaction was detected when data were stratified by English language proficiency, internet access, and education level.Conclusions and ImplicationsPatient satisfaction with telemedicine for palliative symptom management was similar to that for in-person clinic visits. Study was limited by selection bias; 28.42% of patients had died, 40.53% were unreachable. A larger study is needed. Telemedicine is advantageous, and preliminary data support its use.