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System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation

BACKGROUND: As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is not known how patients and physicians responded to an accelerated implementation of this model of medical care. OBJECTIVE: The aim of this study is to report t...

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Autores principales: Garcia-Huidobro, Diego, Rivera, Solange, Valderrama Chang, Sebastián, Bravo, Paula, Capurro, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541041/
https://www.ncbi.nlm.nih.gov/pubmed/32903195
http://dx.doi.org/10.2196/22146
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author Garcia-Huidobro, Diego
Rivera, Solange
Valderrama Chang, Sebastián
Bravo, Paula
Capurro, Daniel
author_facet Garcia-Huidobro, Diego
Rivera, Solange
Valderrama Chang, Sebastián
Bravo, Paula
Capurro, Daniel
author_sort Garcia-Huidobro, Diego
collection PubMed
description BACKGROUND: As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is not known how patients and physicians responded to an accelerated implementation of this model of medical care. OBJECTIVE: The aim of this study is to report the system-wide accelerated implementation of telemedicine, compare patient satisfaction between telemedicine and in-person visits, and report provider perceptions. METHODS: This study was conducted at the UC Christus Health Network, a large private academic health network in Santiago, Chile. The satisfaction of patients receiving telemedicine care in March and April 2020 was compared to those receiving in-person care during the same period (concurrent control group) as well as in March and April 2019 (retrospective control group). Patient satisfaction with in-person care was measured using the Net Promoter Score (NPS) survey. Patient satisfaction with telemedicine was assessed with an online survey assessing similar domains. Providers rated their satisfaction and responded to open-ended questions assessing challenges, strategies used to address challenges, the diagnostic process, treatment, and the patient-provider relationship. RESULTS: A total of 3962 patients receiving telemedicine, 1187 patients from the concurrent control group, and 1848 patients from the retrospective control group completed the surveys. Satisfaction was very high with both telemedicine and in-person services. Overall, 263 physicians from over 41 specialties responded to the survey. During telemedicine visits, most providers felt their clinical skills were challenged (61.8%). Female providers felt more challenged than male providers (70.7% versus 50.9%, P=.002). Surgeons, obstetricians, and gynecologists felt their clinical skills were challenged the least, compared to providers from nonsurgical specialties (P<.001). Challenges related to the delivery modality, diagnostic process, and patient-provider relationship differed by provider specialty (P=.046, P<.001, and P=.02, respectively). CONCLUSIONS: Telemedicine implemented in response to the COVID-19 pandemic produced high patient and provider satisfaction. Specialty groups perceived the impact of this new mode of clinical practice differently.
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spelling pubmed-75410412020-10-20 System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation Garcia-Huidobro, Diego Rivera, Solange Valderrama Chang, Sebastián Bravo, Paula Capurro, Daniel J Med Internet Res Original Paper BACKGROUND: As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is not known how patients and physicians responded to an accelerated implementation of this model of medical care. OBJECTIVE: The aim of this study is to report the system-wide accelerated implementation of telemedicine, compare patient satisfaction between telemedicine and in-person visits, and report provider perceptions. METHODS: This study was conducted at the UC Christus Health Network, a large private academic health network in Santiago, Chile. The satisfaction of patients receiving telemedicine care in March and April 2020 was compared to those receiving in-person care during the same period (concurrent control group) as well as in March and April 2019 (retrospective control group). Patient satisfaction with in-person care was measured using the Net Promoter Score (NPS) survey. Patient satisfaction with telemedicine was assessed with an online survey assessing similar domains. Providers rated their satisfaction and responded to open-ended questions assessing challenges, strategies used to address challenges, the diagnostic process, treatment, and the patient-provider relationship. RESULTS: A total of 3962 patients receiving telemedicine, 1187 patients from the concurrent control group, and 1848 patients from the retrospective control group completed the surveys. Satisfaction was very high with both telemedicine and in-person services. Overall, 263 physicians from over 41 specialties responded to the survey. During telemedicine visits, most providers felt their clinical skills were challenged (61.8%). Female providers felt more challenged than male providers (70.7% versus 50.9%, P=.002). Surgeons, obstetricians, and gynecologists felt their clinical skills were challenged the least, compared to providers from nonsurgical specialties (P<.001). Challenges related to the delivery modality, diagnostic process, and patient-provider relationship differed by provider specialty (P=.046, P<.001, and P=.02, respectively). CONCLUSIONS: Telemedicine implemented in response to the COVID-19 pandemic produced high patient and provider satisfaction. Specialty groups perceived the impact of this new mode of clinical practice differently. JMIR Publications 2020-10-06 /pmc/articles/PMC7541041/ /pubmed/32903195 http://dx.doi.org/10.2196/22146 Text en ©Diego Garcia-Huidobro, Solange Rivera, Sebastián Valderrama Chang, Paula Bravo, Daniel Capurro. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.10.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Garcia-Huidobro, Diego
Rivera, Solange
Valderrama Chang, Sebastián
Bravo, Paula
Capurro, Daniel
System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation
title System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation
title_full System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation
title_fullStr System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation
title_full_unstemmed System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation
title_short System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation
title_sort system-wide accelerated implementation of telemedicine in response to covid-19: mixed methods evaluation
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541041/
https://www.ncbi.nlm.nih.gov/pubmed/32903195
http://dx.doi.org/10.2196/22146
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