Patient satisfaction with telemedicine in gynecologic surgery

Abstract

To evaluate patient satisfaction for in-person vs virtual visits among minimally invasive gynecologic surgery patients before and after implementation of telemedicine during the Covid-19 pandemic. Patient satisfaction surveys from a minimally invasive gynecologic surgery practice at a single academic center were collected. We divided the study period into three 6-month blocks: 1) Pre- implementation of telemedicine (10/01/2019-3/31/2020), 2) Post-implementation (4/01/2020 – 9/30/2020), and 3) Maintenance (10/01/2020-3/31/2021), accounting for improvements in comfort with and technical aspects of the telemedicine platform. We analyzed four patient satisfaction questions: (1) “Did this provider listen carefully to you?”, (2) “Did this provider seem to know your medical history?”, (3) “What number would you use to rate this provider (0-10)?”, and (4) “Would you recommend this provider’s office to your family and friends?”. The percentage of patients who gave responses of 9-10 (“Top Box” scores) were compared between in-person and virtual visits using a two-tailed Z test with an alpha of 0.05. Overall survey response rate was 34.1% with n-responses/question range = 36 to 227. There was no statistically significant difference in satisfaction scores for in-person visits between study time periods. All virtual visit satisfaction metrics improved from the post-implementation to maintenance periods, though provider rating scores did not reach statistical significance (Figure 1). For both post-implementation and maintenance periods, there were no differences in scores between virtual visit and in-person scores for listening, provider rating and recommendation (Table 1). However, perception of provider knowledge of medical history was significantly lower for virtual visits than in-person (post- 69.7% vs 95.0%, z= -3.25, p= 0.001; maintenance- 82.3% vs 93.5%, z= 2.17, p= 0.03). While patient satisfaction scores were unchanged for in-person visits pre and post COVID-19 pandemic, virtual visit satisfaction scores improved over time. There was no difference in patient satisfaction between in-person and virtual visits except for higher perceived provider knowledge of patient’s medical history with in-person visits. This suggests that telemedicine may be a non-inferior alternative for delivery of care for minimally invasive gynecologic surgery practices.View Large Image Figure ViewerDownload Hi-res image Download (PPT)