Abstract
BackgroundLos Angeles County is a hub for COVID-19 cases in the United States. Academic health centers rapidly deployed and leveraged telemedicine to permit uninterrupted care of patients. Telemedicine enjoys high patient satisfaction, yet little is known about the level of satisfaction during a crisis and to what extent patient- or visit-related factors and trust play when in-person visits are eliminated.ObjectiveThe aim of this study is to examine correlates of patients’ satisfaction with a telemedicine visit.MethodsIn this retrospective observational study conducted in our single-institution, urban, academic medical center in Los Angeles, internal medicine patients aged ≥18 years who completed a telemedicine visit between March 10th and April 17th, 2020, were invited for a survey (n=1624). Measures included patient demographics, degree of interpersonal trust in patient-physician relationships (using the Trust in Physician Scale), and visit-related concerns. Statistical analysis used descriptive statistics, Spearman rank-order correlation, and linear and ordinal logistic regression.ResultsOf 1624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (173/365, 47.4%) or satisfied (n=129, 35.3%) with their telemedicine visit. Higher physician trust was associated with higher patient satisfaction (Spearman correlation r=0.51, P<.001). Visit-related factors with statistically significant correlation with Trust in Physician score were technical issues with the telemedicine visit (r=–0.16), concerns about privacy (r=–0.19), concerns about cost (r=–0.23), satisfaction with telemedicine convenience (r=0.41), and amount of time spent (r=0.47; all P<.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=.02), and successful face-to-face video (P<.001). The only patient variable with a significant positive association was income and level of trust in physician (r=0.18, P<.001). Younger age was associated with higher satisfaction with the telemedicine visit (P=.005).ConclusionsThere have been calls for redesigning primary care after the COVID-19 pandemic and for the widespread adoption of telemedicine. Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high. Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has widespread implications for outpatient practices and further research into visit-related factors and the patient-provider connection over telemedicine is needed.
Highlights
On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic; thereafter, telemedicine— video consultation—was promoted and scaled up to reduce the risk of transmission [1,2]
Studies have shown that telemedicine visits enjoy high patient satisfaction [8,9]
Prior studies have shown patients prefer telemedicine with a doctor with whom they have an established relationship [20]. When it comes to specialist referral, trust and confidence in one’s primary care provider are crucial to creating a satisfying experience [21,22]
Summary
On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic; thereafter, telemedicine— video consultation—was promoted and scaled up to reduce the risk of transmission [1,2]. Patient satisfaction with direct-to-consumer telemedicine has been assessed with little or no previous doctor-patient relationship or coordination with the patients’ primary care provider [12]. Patient trust in their provider, an essential foundation for fostering patient satisfaction, has not been well studied in this type of remote care setting [13]. Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has widespread implications for outpatient practices and further research into visit-related factors and the patient-provider connection over telemedicine is needed
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