Satisfaction with rural rheumatology telemedicine service.

Abstract

To assess patient satisfaction with the rheumatology telemedicine service provided to a rural town in northern Australia. A prospective, questionnaire-based exploratory study of patients seen at the Mount Isa (rural town) rheumatology telemedicine clinics during 2012 was undertaken. Control groups included patients travelling over 3h to be seen face-to-face in Townsville (tertiary referral centre), and patients seen at the infrequent face-to-face clinic in Mount Isa. A 5-point Likert scale was used to explore themes of communication, confidentiality, physical examination, rapport, medication safety and access. This study evaluated 107 rheumatology outpatients (49 telemedicine, 46 face-to-face Townsville, 12 face-to-face Mount Isa). Patients seen in Mount Isa travelled a median of <10km for either the telemedicine or local face-to-face appointments. The patients attending the Townsville face-to-face clinic travelled a median of 354km. New patients comprised 14% of consultations. Satisfaction with themes related to quality-of-care was high with over 90% selecting 'agree' or 'strongly agree' to these questions. Comparing models of care, there were no statistically significant differences in the rates of those selecting 'strongly agree' across questions, apart from a single question related to rapport which favored the Mount Isa face-to-face model (P=0.018). When asked whether they would rather travel to Townsville than participate in a telemedicine consultation, 63% of patients selected 'disagree' (17%) or 'strongly disagree' (46%). These results suggest that patients are satisfied with a rheumatology telemedicine service, and may prefer this to extensive travelling. Evaluation in other settings is recommended before generalizing this finding.