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September 25, 2020
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Growing patient preference ensures 'telehealth is here to stay' beyond COVID-19

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A recent survey of some 2,000 Americans on the topic of telemedicine revealed a swift and dramatic shift in attitudes toward telehealth visits in the wake of COVID-19.

These findings are of particular interest for the rheumatology community — which, historically, was slow on the uptake of telemedicine — for two key reasons. One is that telemedicine is not going anywhere. The second is that most patients are on board with this new normal of their medical care.

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“COVID-19 has provided an opportunity for patients to give valuable feedback on their experiences with telehealth, which will help pave the way for the technology post-pandemic and beyond,” Collin Czarnecki told Healio Rheumatology. Source: Adobe Stock

“Overall, convenience was cited as the top factor that patients appreciated the most when using telemedicine or telehealth services,” Collin Czarnecki, a content strategist at Digital Third Coast, a Chicago-based marketing and research company, told Healio Rheumatology. “It appears that a majority of patients feel that telehealth is here to stay, even in a post-pandemic world.”

The critical issue, for the moment, is safety. One striking result of the survey, which was published by Indiana software company Harmony Healthcare IT, showed that 71% of respondents reported fear of visiting a doctor’s office due to COVID-19.

Collin Czarnecki

This fear played out as a dramatic shift in attitudes toward virtual platforms for doctor visits. Prior to the pandemic, 46% of respondents had used telemedicine. Since the pandemic began, that number has ticked up to 67%, with participants reporting an average of 2.9 telemedicine visits since lockdowns, quarantines and social distancing measures took effect.

As the sheer number of telehealth visits increased, patient satisfaction with this mode of health care also increased. While 63% of participants were apprehensive before their first appointment, 72% ultimately reported satisfaction after their visit.

Convenience, at 63%, and safety from virus exposure, at 59%, topped the list of attractive qualities of telehealth, but these were not the only factors driving patient satisfaction. “Safety and flexibility were also among the main factors that patients reported enjoying,” Czarnecki, who was lead investigator in the survey, said in the interview. “Most telehealth services give patients flexibility when scheduling visits and confirming follow-ups.”

The numbers underscore this message, with 46% citing flexibility as an appealing quality for telehealth. Czarnecki added that reduced wait time for doctor visits also was cited by 35% of participants surveyed.

Just shy of one-quarter of patients reported that the comfort of being at home made them satisfied with telehealth. In addition, they reported that scheduling follow-up visits was easier with telemedicine (18%) and that communication with their health care professional was improved using virtual platforms (16%).

“Telehealth also allows patients to see their provider through the comfort, safety and convenience of their own home,” Czarnecki said.

Respondents reported using telehealth to see a wide variety of medical providers. Virtual appointments with primary care physicians were the most common, at 59%, followed by 11% for both cardiologists and neurologists and 6% for oncologists. “Other specialist fields such as gastroenterology, endocrinology and rheumatology were cited, but they did not rank high among the other specialists listed,” Czarnecki said. “This could be due to the limitations of virtual visits and patients preferring a more hands-on, in-person visit when seeing these types of specialists.”

Other Areas for Improvement

“Despite its benefits, there are several areas where telehealth can make improvements,” Czarnecki said. Further findings from the survey showed that 43% of patients had concerns over privacy and security when using telehealth.

“This could be partly due to generational differences,” Czarnecki said. “Tech-savvy millennials reported feeling more comfortable using telehealth, while other generations, such as Gen X and baby boomers, reported being the least comfortable with using telehealth.”

The researchers believe there is valid reason for these concerns, given that telehealth is a “new frontier” in medicine, according to Czarnecki. “Considering that younger patients in the millennial age group grew up with technology, they may be more open to accepting and adapting to telehealth, whereas other age groups may take a more cautious approach,” he said. “It’s understandable why there might be hesitation around using the service, especially if patients are using it for the first time.”

Another potential drawback was technical difficulties in the actual communication platform or device, which was reported by one-third of participants. “Along with security and privacy, providers may want to look into improving the stability of their connection during telehealth visits,” Czarnecki said.

With this in mind, the investigators also queried respondents on the hardware and software used in communicating with their doctors. “Video conferencing platforms like Zoom have experienced explosive growth since the pandemic, so it may not come as a surprise that patients cited Zoom as their most preferred platform,” Czarnecki said. “Zoom was followed closely by a medical provider’s internal app or website and Skype.”

While patients are able to communicate via phone, tablet or computer, preferences on the device were clear, according to Czarnecki. “Patients reported using a computer as their most preferred way to connect,” he said.

Here to Stay

The survey also included questions about what the future holds for telemedicine. Results showed that 66% of respondents reported that telehealth will replace in-person doctor visits that do not require hands-on exams. Another 52% said they would see their doctor or medical provider more often if they could do so through telehealth.

In addition, despite the aforementioned concerns over privacy and security, 70% of patients surveyed feel telehealth provides adequate care. “It is also interesting to note that patients reported feeling the most comfortable describing their symptoms via telehealth,” Czarnecki said. “This could be due to the convenience factor and patients feeling more at ease talking about their symptoms in the privacy of their home.”

Given that telemedicine seems to be the way of the future, Czarnecki said it will be important for those in the health care community to address the disadvantages and concerns of patients. “There are certainly a number of improvements that patients would like to see, such as increased security and privacy as well as making the service more affordable and more broadly adopted,” he said.

Despite these requests, patients are currently not giving up on telehealth, according to Czarnecki. “As telehealth continues to evolve, both patients and medical providers will be taking the journey together,” he said. “COVID-19 has provided an opportunity for patients to give valuable feedback on their experiences with telehealth, which will help pave the way for the technology post-pandemic and beyond.”