Clinician survey highlights benefits of telehealth for cystic fibrosis care delivery

In a survey of clinicians at seven U.S. cystic fibrosis programs, telehealth for cystic fibrosis care delivery was feasible and well accepted.

“Telehealth was well accepted, and our findings highlight the utility of telehealth for enhancing interdisciplinary cystic fibrosis health care delivery,” Ryan C. Perkins, MD, physician of adolescent medicine at Boston Children’s Hospital and Brigham and Women’s Hospital, and colleagues wrote in the Annals of the American Thoracic Society. “Future studies are needed to understand its impact on clinical and patient-reported outcomes.”

Researchers distributed cross-sectional web-based surveys to physicians, nurse practitioners, physician’s assistants, registered nurses and dietitians, social workers, mental health providers, pharmacists, and respiratory and physician therapists at seven U.S. cystic fibrosis programs. The survey included questions concerning the construct of current telehealth visits, perceptions surrounding experiences with telehealth and preferences for future telehealth care. The survey was conducted from May to June 2020 and a follow-up survey was distributed from August to September 2020.

Of 80 clinicians surveyed, 63 completed the follow-up survey. Ninety percent reported never previously utilizing telehealth, 83% reported receiving adequate training before implementing telehealth and 65% reported completing more than 10 telehealth visits at the time of the survey. The most commonly available platform for telehealth visits was Zoom, used by about 57% of respondents.

An interdisciplinary asynchronous format, with multiple clinicians evaluating patients sequentially in the same visit, was utilized by 48% of respondents. Most visits (up to 95%) reported incorporating audio plus video connectivity. A computer was used for access in 89% of respondents and most visits were conducted from the clinician’s home (57%). Eighty-three percent of respondents reported experiencing at last one technical complication after implementation, with 88% able to complete the telehealth visit despite the complications.

Despite barriers to use, 78% of respondents reported that none or few of the patients evaluated via telehealth should also be evaluated in person, but this decreased to 68% at follow-up (P = .04).

Across both the initial and follow-up assessments, satisfaction (86% and 89%, respectively), positive impact on clinician-patient relationship (58% and 57%, respectively) and improved efficiency (56% for both) remained consistent.

When asked about future telehealth visits at the follow-up assessment, 99% of clinicians preferred that some or most visits be performed using telehealth, in particular, quarterly telehealth visits (95%) and hospital follow-up (61%).

In total, 89% of respondents at follow-up showed interest in technology used to remotely assess oximetry or lung function in patients.