Pediatric Ophthalmology Provider and Staff Attitudes and Patient Satisfaction in Telehealth Implementation During COVID-19

Abstract

Purpose:Describe a comprehensive overview of a telehealth implementation process that highlights attitudes and satisfaction scores toward telehealth from patients, providers, and staff in an academic pediatric ophthalmology practice during the early months of the coronavirus disease 2019 (COVID-19) pandemic.Methods:The electronic medical record data for telehealth and in-person visits, as well as a patient experience survey in pediatric ophthalmology were retrospectively reviewed for March 1 to July 31, 2020 and March 1 to July 31, 2019. Patient experience survey results were retrospectively reviewed. All current providers and staff were invited to participate in an anonymous and voluntary survey focused on attitudes at the time of telehealth implementation.Results:During March 1 to July 31, 2020, there was significant increase in telehealth visits (n = 1,006) compared with the same period in 2019 (n = 22). Evaluation and management (E & M) codes (n = 527) were the most commonly used billing codes, and strabismus, nystagmus, and irregular eye movement (n = 496) were the most common telehealth primary diagnoses. The telehealth attitudes survey showed more positive responses from providers than staff. The patient experience survey showed more favorable scores for telehealth visits compared with clinic visits. However, only about 50% of the respondents were satisfied with the technology in terms of ease and quality of connection during their telehealth visits.Conclusions:Telehealth was a satisfactory alternative to clinic visits in our academic pediatric ophthalmology practice during the early phase of the COVID-19 pandemic. Providers and staff had largely positive attitudes toward telehealth; however, future efforts should include strategies to increase staff buy in. Patients had high satisfaction scores with telehealth visits despite connection challenges.

Keywords: COVID-19; ophthalmology; patient satisfaction; pediatric; provider and staff attitudes; telehealth.

Fig. 1.

Telehealth adoption from March 1, 2020 to July 31, 2020. After office visits were curtailed in mid-March, telehealth visits were initiated. In-person office visits were increased at the beginning of May and again at the beginning of June. By mid-July, the weekly volume of visits was similar to the mean weekly volume of the same time period in 2019 (baseline).

Fig. 2.

Attitudes toward telehealth across the department of ophthalmology. The distribution of respondents' answers to survey questions is represented by stacked bar charts divided into disagree, neutral, and agree response categories. Overall, more staff reported neutral attitudes about telehealth than providers did.

Fig. 3.

Pediatric providers' and staff's attitudes toward telehealth. The distribution of respondents' answers to survey questions is represented by stacked bar charts divided into disagree, neutral, and agree response categories. Overall, more staff reported neutral attitudes and providers reported primarily positive attitudes about telehealth.