Exploring Patient and Staff Experiences With Video Consultations During COVID-19 in an English Outpatient Care Setting: Secondary Data Analysis of Routinely Collected Feedback Data

Abstract

Background Video consultations (VCs) were rapidly implemented in response to COVID-19 despite modest progress before. Objective We aim to explore staff and patient experiences with VCs implemented during COVID-19 and use feedback insights to support quality improvement and service development. Methods Secondary data analysis was conducted on 955 patient and 521 staff responses (from 4234 consultations; 955/4234, 22.6% and 521/4234, 12.3%, respectively) routinely collected following a VC between June and July 2020 in a rural, older adult, and outpatient care setting at a National Health Service Trust. Responses were summarized using descriptive statistics and inductive thematic analysis and presented to Trust stakeholders. Results Most patients (890/955, 93.2%) reported having good (210/955, 22%) or very good (680/955, 71.2%) experience with VCs and felt listened to and understood (904/955, 94.7%). Most patients accessed their VC alone (806/955, 84.4%) except for those aged ≥71 years (23/58, 40%), with ease of joining VCs negatively associated with age (P<.001). Despite more difficulties joining, older adults were most likely to be satisfied with the technology (46/58, 79%). Patients and staff generally felt that patients’ needs had been met (860/955, 90.1% and 453/521, 86.9%, respectively), although staff appeared to overestimate patient dissatisfaction with VC outcomes (P=.02). Patients (848/955, 88.8%) and staff (419/521, 80.5%) felt able to communicate everything they wanted, although patients were significantly more positive than staff (P<.001). Patient satisfaction with communication was positively associated with technical performance satisfaction (P<.001). Most staff members (466/521, 89.4%) reported positive (185/521, 35.5%) or very positive (281/521, 53.9%) experiences with joining and managing VCs. Staff reported reductions in carbon footprint (380/521, 72.9%) and time (373/521, 71.6%). Most patients (880/955, 92.1%) would choose VCs again. We identified three themes in responses: barriers, including technological difficulties, patient information, and suitability concerns; potential benefits, including reduced stress, enhanced accessibility, cost, and time savings; and suggested improvements, including trial calls, turning music off, photo uploads, expanding written character limit, supporting other internet browsers, and shared online screens. This routine feedback, including evidence to suggest that patients were more satisfied than clinicians had anticipated, was presented to relevant Trust stakeholders, allowing for improved processes and supporting the development of a business case to inform the Trust decision on continuing VCs beyond COVID-19 restrictions. Conclusions The findings highlight the importance of regularly reviewing and responding to routine feedback following digital service implementation. The feedback helped the Trust improve the VC service, challenge clinician-held assumptions about patient experience, and inform future use of VCs. It has focused improvement efforts on patient information; technological improvements such as blurred backgrounds and interactive whiteboards; and responding to the needs of patients with dementia, communication or cognitive impairment, or lack of appropriate technology. These findings have implications for other health care providers.

Telerehabilitation for physical disabilities and movement impairment: A service evaluation in South West England

“…In a US survey conducted during the COVID‐19 pandemic, patients experiencing virtual physical, occupational and speech and language therapy reported numerous benefits of remote therapy and high levels of satisfaction with their care 19 . Positive experiences of virtual outpatient clinics have been reported by patients in the UK, 20 Australia 21 and Israel 22 . Our survey of UK rehabilitation practitioners found generally positive perceptions and satisfaction with telerehabilitation 9 .…”

“…The challenges most frequently discussed by practitioners and patients were: technical issues (usability problems with hardware and software, difficulties accessing technology and a lack of digital skills); difficulty seeing or hearing patients; concerns about the lack of ‘hands‐on’ care; and safety concerns. Technical issues, experienced by both practitioners and patients, are a frequently reported barrier to telerehabilitation 20,22,25,26 . Problems with seeing or hearing patients, and practitioners’ concerns about the lack of ‘hands‐on’ care have also been reported previously 27–29 .…”

Patient and clinician experiences of remote consultation during the SARS-CoV-2 pandemic: A service evaluation

“…Studies do show high levels of patient satisfaction with remote consultations, especially when this resulted in speedier contact with a health care professional, 10 , 17 – 20 with timely access, rather than the mode of consultation being the most important to patients. 18 Current evidence in this area indicates that there may be indicators of patients most likely to find remote consultations preferable to face-to-face, including gender (female) and those with higher patient-activation scores.…”

“…[11][12][13][14] In the later stages of the SARS-CoV-2 pandemic, the focus broadened with reports of evaluations of remote consultation in secondary care showing encouraging levels of satisfaction from both clinicians and patients. 15,16 Studies do show high levels of patient satisfaction with remote consultations, especially when this resulted in speedier contact with a health care professional, 10,[17][18][19][20] with timely access, rather than the mode of consultation being the most important to patients. 18 Current evidence in this area indicates that there may be indicators of patients most likely to find remote consultations preferable to face-to-face, including gender (female) and those with higher patient-activation scores.…”

“…15,16 Studies do show high levels of patient satisfaction with remote consultations, especially when this resulted in speedier contact with a health care professional, 10,[17][18][19][20] with timely access, rather than the mode of consultation being the most important to patients. 18 Current evidence in this area indicates that there may be indicators of patients most likely to find remote consultations preferable to face-to-face, including gender (female) and those with higher patient-activation scores. 21 However, there are concerns over barriers to those with no or little access to digital devices, language barriers, learning difficulties, and digital illiteracy, the elderly or older adults as they may be reluctant to use digital means for healthcare services which challenge any blanket provision.…”