Journal
JOURNAL OF NEUROLOGY
Volume 269, Issue 9, Pages 5022-5037Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00415-022-11149-0
Keywords
Clinical neurology; Practice management; COVID-19; Telehealth; Telemedicine
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Patients consider factors such as the pros and cons of different visit types, barriers to telemedicine, situational context, inherent beliefs, and extrinsic variables when choosing between in-person, video, or telephone visits. They perceive convenience and monitoring of stable conditions as advantages of telemedicine, while improved quality of care and physical examination are associated with in-person visits. Accessibility, user familiarity, and system limitations are identified as barriers to telemedicine. Patients with in-person visits need to be more aware of telemedicine. Implementing hybrid models that incorporate telemedicine as an adjunct to in-person visits in ambulatory neurology is recommended.
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.
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