S1531 How Type of Office Visit Influences Attitudes and Preferences for Telemedicine

Abstract

Introduction: The COVID-19 pandemic caused significant changes in delivery of healthcare. Telemedicine emerged as a popular option. Numerous studies demonstrate a favorable opinion of telemedicine from patient and physician perspectives. What factors make it more efficient and effective? This study explores how type of office visit impacts attitudes towards telemedicine and affects patient’s preferences for future visits. Methods: Surveys were delivered by mail or in person to 1,100 randomly selected patients of Sierra Nevada Gastroenterology, a community-based practice in Grass Valley, CA. Each patient (pt) had a telemedicine visit (TMV) from April 2020-October 2021. Three hundred twenty surveys were returned completed. Surveys contained a 5-point Likert scale set of questions rating the quality, communication, compassion, thoroughness and convenience of TMV. In person visits (IPV) were then directly compared to TMV for the same qualities. Demographics were recorded (Table 1). Surveys were separated into 3 categories based on type of visit: new complaint (NC), follow-up of existing problem (FU), procedure-related visit (PRV). Statistical analysis and chi-square test were used to determine statistical significance. Results: Quality, communication, thoroughness and compassion during TMV rated high with Likert scores of 4.3-4.7 (5 = strongly agree) for all groups. Comparing the 3 groups (NC, FU, PRV) with chi-square testing, no statistical difference in ratings was seen. FU pts had the highest Likert scores in all categories. Pts with new complaints preferred IPV over TMV for quality, communication, thoroughness and compassion, which was rated statistically significantly higher (P < 0.05). TMV was favored for convenience in all groups with highest ranking in FU pts (73%). Conclusion: This study showed type of office visit did not affect satisfaction or ratings of TMV. However, type of visit did reveal preferences for either IPV or TMV. Pts with NC preferred IPV and felt compassion is important and delivered more effectively in person. This suggests non-verbal communication such as body language, facial expression and tone is conveyed more effectively in person than over phone or video calls. FU or PRV pts rated TMV as more convenient and preferable over IPV for future visits, suggesting that pts with stable or less acute problems prioritize convenience over other factors when selecting type of visit. Further studies are needed to determine what other factors will influence and improve quality of TMV. Table 1. - New Complaint * (n=220) Follow-up Visit (n=45) Procedure Related Visit **(n=55) Gender Male/Female 113/107 21/24 17/38 Age < 39 years old 10 4 2 40-49 11 3 4 50-59 47 10 10 60-69 69 8 13 70-79 70 16 20 80+ 12 3 6 Ethnicity White 194 41 48 Black 1 0 1 Hispanic 9 3 0 Asian 7 1 3 Other 3 0 0 *New complaints include abdominal pain, change in bowels, heartburn, nausea or vomiting, liver problems or inflammatory bowel disease.**Procedure Related Visit focused primarily on setting up scope (e.g., screening for colon cancer, surveillance of polyps or Barrett's).