Patient Satisfaction, Provider Productivity, and Efficacy of a Standardized Preparatory Toolkit With Broad Telemedicine Adaptation in an Outpatient Urology Clinic.

Abstract

The COVID-19 pandemic prompted telemedicine adoption. In March 2020, we developed an implementation toolkit with a nursing protocol for patient preparation before tertiary care urology clinic visits. Our primary objective was to determine patient satisfaction after implementation of a telemedicine toolkit. Our secondary objective was to assess downstream productivity generated from telehealth visits. We prospectively conducted a postvisit survey that included the Telehealth Usability Questionnaire, a validated survey assessing patient satisfaction, for all patients with documented completion of the nursing protocol to assess patient experience and satisfaction. We then performed a retrospective chart review of all telemedicine visits to determine downstream outcomes, including imaging and procedure scheduling. Between April and May 2020, 1,422 visits were completed, of which 265 had complete nursing protocol documentation. Eighteen of 265 (6.8%) reported setup assistance. Four (1.8%) were unsuccessful and converted to a nonvisual phone visit. Overall, 186 (70.1%) completed the Telehealth Usability Questionnaire with a mean score of 118.31 ± 23.44. High satisfaction was reported regardless of race, marital status, income, education, employment status, or travel distance. Younger age ( P = 0.017) and female sex ( P = 0.017) were associated with greater satisfaction. Of 1,422 total visits, imaging was ordered in 29%, office procedures scheduled in 14%, and surgery scheduled in 14%. New visits were more likely to result in procedure and surgery scheduling than returns ( P < 0.0001). Our telemedicine toolkit designed to maximize patient engagement was successful in achieving patient-provider connectivity in 98% of patients with high satisfaction. Telemedicine visits are effective to provide comprehensive urologic care with implications beyond the pandemic.