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. 2022 Sep;269(9):5022-5037.
doi: 10.1007/s00415-022-11149-0. Epub 2022 May 5.

A comparison of telemedicine and in-person neurology visits: what are the factors that patients consider when selecting future visit type?

Carly Olszewski  1 , Sharon Thomson  1 , Kelly Pring  1 , Siobhan Cox  1 , Rebecca Merrill  1 , Emily Fishman  1 , Alexander Ambrosini  1 , Kevin Alexander Soltany  1 , Gabby Bognet  2 , Lauren Strauss  3 , Rachel Graham  3 , Amy Guzik  3 , Roy E Strowd  4
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A comparison of telemedicine and in-person neurology visits: what are the factors that patients consider when selecting future visit type?

Carly Olszewski et al. J Neurol. 2022 Sep.

Abstract

Objective: To identify factors that patients consider when choosing between future in-person, video, or telephone visits.

Background: Telemedicine has been rapidly integrated into ambulatory neurology in response to the COVID-19 pandemic.

Methods: Ambulatory neurology patients at a single center were contacted via telephone to complete: (1) a survey quantifying likelihood of scheduling a future telemedicine visit, and (2) a semi-structured qualitative interview following their visit in March 2021. Data were processed using the principles of thematic analysis.

Results: Of 2493 visits, 39% assented to post-visit feedback; 74% were in-person visits and 13% video and telephone. Patients with in-person visits were less likely than those with video and telephone visits to "definitely" consider a future telemedicine visit (36 vs. 59 and 62%, respectively; p < 0.001). Patients considered five key factors when scheduling future visits: "Pros of Visit Type," "Barriers to Telemedicine," "Situational Context," "Inherent Beliefs," and "Extrinsic Variables." Patients with telemedicine visits considered convenience as a pro, while those with in-person visits cited improved quality of care. Accessibility and user familiarity were considered barriers to telemedicine by patients with in-person and telephone visits, whereas system limitations were prevalent among patients with video visits. Patients agreed that stable conditions can be monitored via telemedicine, whereas physical examination warrants an in-person visit. Telemedicine was inherently considered equivalent to in-person care by patients with telephone visits. Awareness of telemedicine must be improved for patients with in-person visits.

Conclusion: Across visit types, patients agree that telemedicine is convenient and effective in many circumstances. Future care delivery models should incorporate the patient perspective to implement hybrid models where telemedicine is an adjunct to in-person visits in ambulatory neurology.

Keywords: COVID-19; Clinical neurology; Practice management; Telehealth; Telemedicine.

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Conflict of interest statement

Carly Olszewski has no relevant financial or non-financial interests to disclose. Sharon Thomson has no relevant financial or non-financial interests to disclose. Kelly Pring has no relevant financial or non-financial interests to disclose. Siobhan Cox has no relevant financial or non-financial interests to disclose. Rebecca Merrill has no relevant financial or non-financial interests to disclose. Emily Fishman has no relevant financial or non-financial interests to disclose. Alexander Ambrosini has no relevant financial or non-financial interests to disclose. K. Alexander Soltany has no relevant financial or non-financial interests to disclose. Gabby Bognet has no relevant financial or non-financial interests to disclose. Dr. Lauren D. Strauss has no relevant financial or non-financial interests to disclose. Rachel Graham has no relevant financial or non-financial interests to disclose. Dr. Amy Guzik has no relevant financial or non-financial interests to disclose. Dr. Roy E. Strowd serves as a consultant for Monteris Medical Inc., Novocure, and Nanobiotix. He receives an editorial stipend as Deputy Section Editor of the Resident and Fellow Section of Neurology® and has received research/grant support from the American Academy of Neurology, American Society for Clinical Oncology, Southeastern Brain Tumor Foundation, and Jazz Pharmaceuticals.

Figures

Fig. 1
Fig. 1
Patient responses to Question 2 of the quantitative telephone survey stratified by patient-reported visit type (in-person: n = 939; video: n = 120; telephone: n = 120). A significant difference (p < 0.01*) was found between the (1) patients who had in-person and video visits and (2) patients who had in-person and telephone visits who would “definitely” consider a future telemedicine visit
Fig. 2
Fig. 2
Summary of five meta-themes that characterize the factors that patients consider when choosing between future in-person, video, and telephone visits. Patient values were inferred from prevalent meta-themes of each visit type
See this image and copyright information in PMC

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