Transition to virtual appointments for interventional neuroradiology due to the COVID-19 pandemic: a survey of satisfaction

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Abstract

Background

The COVID-19 pandemic has changed the way medicine is practiced, including the implementation of virtual care in many specialties. In the field of interventional neuroradiology (INR), virtual clinics are an uncommon practice with minimal literature to support its use. Our objective was to report prospective, single-centre data regarding patient and physician experience with virtual INR clinics for routine follow-up appointments.

Methods

We surveyed all patients that participated in a virtual INR clinic follow-up appointment at our hospital over a 3 month period. Information gathered included length of appointment delays (ie, wait times), length of appointment times, overall satisfaction, and perceived safety metrics. A survey was also sent out to all physicians who participated in virtual clinics with similar questions.

Results

118/122 patients and 6/6 physicians completed the survey. Wait times before previous in-person appointments were perceived to be much longer than virtual appointments, whereas in-person appointment times were longer. 112/118 (94.9%) patients and 4/6 (67%) physicians reported general satisfaction with their virtual clinic experience. There were 8/118 patients who felt their conditions could not be safely assessed virtually, compared with 1/6 (17%) physicians. Lastly, 72.2% of patients reported that they would prefer virtual or telephone visits in the future for non-urgent follow-up, and 5/6 (83%) of physicians reported the same.

Conclusion

Virtual INR clinics are more efficient and are preferred among patients and physicians for non-urgent follow-up appointments. Our study demonstrates the feasibility of a virtual platform for INR care, which could be sustainable for future practice.

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Most cited references 6

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Virtual Ophthalmology: Telemedicine in a Covid-19 Era

Sophia Saleem, Louis Pasquale, Paul A Sidoti … (2020)

Purpose To discuss the effects of the SARS-Cov-2 betacoronavirus on ambulatory ophthalmology practices, the value proposition of telemedicine, tele-ophthalmology implementation methodologies, and the accelerated future of telemedicine. Design Review of the current telehealth landscape including usage, policies, and techniques for ambulatory practice integration. Methods We provide author-initiated review of recent trends in telehealth, governmental recommendations for healthcare delivery during the COVID-19 pandemic, and a PubMed Central query for telemedicine in ophthalmology or tele-ophthalmology. In addition, authors’ comprehensive experience in telemedicine design and implementation is provided. Results A summary describing the present state of telehealth, tele-ophthalmology modeling, care delivery, and the proposed impact of telehealth surges on the future of ophthalmology practice. Conclusion Recent patient and provider interest in telemedicine, the relaxation of regulatory restrictions, increased remote care reimbursement, and ongoing social distancing practices compels many ophthalmologists to consider virtualizing services.

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Rapid implementation of virtual neurology in response to the COVID-19 pandemic

Scott N Grossman, Steven C. Han, Laura Balcer … (2020)

The COVID-19 pandemic is causing world-wide social dislocation, operational and economic dysfunction, and high rates of morbidity and mortality. Medical practices are responding by developing, disseminating and implementing unprecedented changes in health care delivery. Telemedicine has rapidly moved to the frontline of clinical practice due to the need for prevention and mitigation strategies; these have been encouraged, facilitated, and enabled by changes in government rules and regulations and payer-driven reimbursement policies. We describe our neurology department’s situational transformation from in-person outpatient visits to a largely virtual neurology practice in response to the COVID-19 pandemic. Two key factors enabled our rapid deployment of virtual encounters in neurology and its subspecialties. The first was a well-established robust information technology infrastructure supporting virtual urgent care services at our institution; this connected physicians directly to patients using both the physician’s and the patient’s own mobile devices. The second is the concept of one patient, one chart, facilitated by a suite of interconnected electronic medical record (EMR) applications on several different device types. We present our experience with conducting general teleneurology encounters using secure synchronous audio and video connections integrated with an EMR. This report also details how we perform virtual neurological examinations that are clinically meaningful, and how we document, code and bill for these virtual services. Many of these processes can be used by other neurology providers, regardless of their specific practice model. We then discuss potential roles for teleneurology after the COVID-19 global pandemic has been contained.

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Patient Satisfaction with Virtual Obstetric Care.

Jin Mou, Bethann Mangel Pflugeisen (2017)

Introduction The importance of patient satisfaction in US healthcare is increasing, in tandem with the advent of new patient care modalities, including virtual care. The purpose of this study was to compare the satisfaction of obstetric patients who received one-third of their antenatal visits in videoconference ("Virtual-care") compared to those who received 12-14 face-to-face visits in-clinic with their physician/midwife ("Traditional-care"). Methods We developed a four-domain satisfaction questionnaire; Virtual-care patients were asked additional questions about technology. Using a modified Dillman method, satisfaction surveys were sent to Virtual-care (N = 378) and Traditional-care (N = 795) patients who received obstetric services at our institution between January 2013 and June 2015. Chi-squared tests of association, t-tests, logistic regression, and ANOVA models were used to evaluate differences in satisfaction and self-reported demographics between respondents. Results Overall satisfaction was significantly higher in the Virtual-care cohort (4.76 ± 0.44 vs. 4.47 ± 0.59; p < .001). Parity ≥ 1 was the sole significant demographic variable impacting Virtual-care selection (OR = 2.4, 95% CI: 1.5-3.8; p < .001). Satisfaction of Virtual-care respondents was not significantly impacted by the incorporation of videoconferencing, Doppler, and blood pressure monitoring technology into their care. The questionnaire demonstrated high internal consistency as measured by domain-based correlations and Cronbach's alpha. Discussion Respondents from both models were highly satisfied with care, but those who had selected the Virtual-care model reported significantly higher mean satisfaction scores. The Virtual-care model was selected by significantly more women who already have children than those experiencing pregnancy for the first time. This model of care may be a reasonable alternative to traditional care.