Telehealth versus face-to-face visits: A comprehensive outpatient perspective-based cohort study of patients with kidney disease.

Lagu A Androga,Suzanne M Norby,Rachel H Amundson,Jason K Viehman,Robert C Albright,Vesna D Garovic,Ziad Zoghby,Andrea G Kattah,Latonya J Hickson,Bjoerg Thorsteinsdottir,Sandhya Manohar,Abhishek Makkar

doi:10.1371/journal.pone.0265073

Abstract

Telenephrology has become an important health care delivery modality during the COVID-19 pandemic. However, little is known about patient perspectives on the quality of care provided via telenephrology compared to face-to-face visits. We aimed to use objective data to study patients' perspectives on outpatient nephrology care received via telenephrology (phone and video) versus face-to-face visits. We retrospectively studied adults who received care in the outpatient Nephrology & Hypertension division at Mayo Clinic, Rochester, from March to July 2020. We used a standardized survey methodology to evaluate patient satisfaction. The primary outcome was the percent of patients who responded with a score of good (4) or very good (5) on a 5-point Likert scale on survey questions that asked their perspectives on access to their nephrologist, relationship with care provider, their opinions on the telenephrology technology, and their overall assessment of the care received. Wilcoxon rank sum tests and chi-square tests were used as appropriate to compare telenephrology versus face-to-face visits. 3,486 of the patient encounters were face-to-face, 808 phone and 317 video visits. 443 patients responded to satisfaction surveys, and 21% of these had telenephrology encounters. Established patients made up 79.6% of telenephrology visits and 60.9% of face-to-face visits. There was no significant difference in patient perceived access to health care, satisfaction with their care provider, or overall quality of care between patients cared for via telenephrology versus face-to-face. Patient satisfaction was also equally high. Patient satisfaction was equally high amongst those patients seen face-to-face or via telenephrology.

Highlights

In early 2020, the novel Coronavirus (COVID-19) emergency resulted in the cancellation of more than 70% of face-to-face patient visits [1] as people sought to avoid infection by staying away from healthcare institutions, and many states instituted stay at home orders
The primary outcome was the percent of patients who responded with a score of good (4) or very good (5) on a 5-point Likert scale on survey questions that asked their perspectives on access to their nephrologist, relationship with care provider, their opinions on the telenephrology technology, and their overall assessment of the care received
Patient satisfaction was high amongst those patients seen face-to-face or via telenephrology

Summary

Introduction

In early 2020, the novel Coronavirus (COVID-19) emergency resulted in the cancellation of more than 70% of face-to-face patient visits [1] as people sought to avoid infection by staying away from healthcare institutions, and many states instituted stay at home orders. There is, a dearth of objective data on patient perceptions of the quality of care provided via telehealth, and in particular, telenephrology, compared to patient perceptions regarding quality of care provided via face-to-face visits. There is limited data on the types of telenephrology health care delivery models (telehealth only versus face-to-face interactions supported by telehealth) that would best serve the needs of patients while reducing health care costs. There is still little known regarding long term patient and provider perspectives on the use of telenephrology. Little is known about patient perspectives on the quality of care provided via telenephrology compared to face-to-face visits. We aimed to use objective data to study patients’ perspectives on outpatient nephrology care received via telenephrology (phone and video) versus face-to-face visits

Objectives

Methods

Findings

Conclusion