Patient Satisfaction and Perception of Physician Empathy in Outpatient Community General Neurology Telemedicine

Abstract

Abstract
 Introduction: We assessed patients’ satisfaction and perception of physician empathy after implementation of video telemedicine service for general neurology follow-up visits at two community spoke clinics that serve patients in rural areas located approximately 45 miles from a medical center hub.
 Methods: Consecutive patients who completed a telemedicine neurology follow-up visit from February 12, 2020 to January 13, 2021 at the spoke clinic in Red Wing, MN and from July 21, 2021 to January 21, 2022 at the spoke clinic in Austin, MN were asked to complete a paper-based survey at the conclusion of the telemedicine visit. The neurologist conducted the telemedicine visit from the medical center hub site in Rochester, MN or from their own home using the InTouch (Teladoc Health™) operating system mobile telehealth platform. All patients had previously completed an initial traditional face-to-face consultation at the spoke clinic with the same neurologist performing the follow-up telemedicine visit. Primary outcomes were Telemedicine Patient Satisfaction Measure and Consultation and Relational Empathy scores and mean total favorable survey responses.
 Results: 31 patients at our clinic in Red Wing, MN and 38 patients at our clinic in Austin, MN participated in telemedicine neurology follow-up visit, completed the survey, and were included in the final analysis.
 The mean Telemedicine Patient Satisfaction Measure scores (possible score of 12-60) were 55 (range 42-60), and for all items ‘agree’ or ‘strongly agree’ was rated on average 94% of the time. The mean Consultation and Relational Empathy scores (possible score of 10–50) were 44 (range 28–50), and for all items ‘very good’ or ‘excellent’ was rated on average 90% of the time. 
 Both neurologists conducting telemedicine visits reported that this model of care improved work-life balance with reduced travel time.
 Discussion: We successfully implemented a telemedicine service for general neurology follow-up visits at two community spoke clinics serving patients in rural areas without compromising on perceived care. We were able to bridge the gap between patients’ needs for local care and physicians’ need for work-life balance. Patients’ perception of physician empathy and satisfaction with telemedicine neurology follow-up visits was high. This model of telemedicine avoids the barriers of limited internet access in rural areas and minimizes technology related anxiety that is often present in telemedicine visits to patients’ homes. This model allowed for high quality neurological examination with high resolution pan-tilt-zoom camera on a mobile platform, incorporation of vital signs, nursing support, and lab services that may have contributed to the patients’ and neurologists’ satisfaction. Our study supports our continuation and expansion of this TM model in our community clinic spoke sites and may help to improve access to neurological care for patients in rural areas.
 Keywords: Telemedicine, patient satisfaction, empathy, general neurology, teleneurology