LoVE in a time of CoVID: Clinician and patient experience using telemedicine for chronic epilepsy management

Abstract

As part of our ongoing interest in patient-and family-centered care in epilepsy, we began, before the onset of the CoVID-19 pandemic, to evaluate the concerns and preferences of those delivering and receiving care via telemedicine. CoVID-19 arrived and acted as an unexpected experiment in nature, catalyzing telemedicine's widespread implementation across many disciplines of medicine. The arrival of CoVID-19 in Ireland gave us the opportunity to record these perceptions pre-and post-CoVID. Data were extracted from the National Epilepsy Electronic Patient Record (EEPR). Power BI Analytics collated data from two epilepsy centers in Dublin. Analysis of data on reasons for using the telephone support line was conducted. A subset of patients and clinicians who attended virtual encounters over both periods were asked for their perception of telemedicine care through a mixed methods survey. Between 23rd December 2019 and 23rd March 2020 (pre-CoVID era), a total of 1180 patients were seen in 1653 clinical encounters. As part of a telemedicine pilot study, 50 of these encounters were scheduled virtual telephone appointments. Twenty eight surveys were completed by clinicians and 18 by patients during that period. From 24th March 2020 to 24th June 2020, 1164 patients were seen in 1693 encounters of which 729 (63%) patients were seen in 748 scheduled virtual encounters. 118 clinician impressions were captured through an online survey and 75 patients or carers completed a telephone survey during the post-CoVID era. There was no backlog of appointments or loss of care continuity forced by the pandemic. Clinicians expressed strong levels of satisfaction, but some doubted the suitability of new patients to the service or candidates for surgery receiving care via telemedicine. Patients reported positive experiences surrounding telephone appointments comparing them favorably to face-to-face encounters. The availability of a shared EEPR demonstrated no loss of care contact for patients with epilepsy. The survey showed that telemedicine is seen as an effective and satisfactory method of delivering chronic outpatient care.

The Research on Patient Satisfaction with Remote Healthcare Prior to and during the COVID-19 Pandemic

“…Logically speaking, the review of concept and theoretical notions should take place prior to the measurement of this construct, while the analysed papers studied patient satisfaction in the reverse order. There were also papers in which satisfaction was not defined at all [43,[46][47][48][49]53,56,61,[64][65][66][67]72,80]. Taking into account both the survey questionnaires developed by the authors as well as well-defined, known, validated and reliable measures, these treat satisfaction as a multi-dimensional construct.…”

Developments in healthcare information systems in Ireland and internationally

“…Telemedicine has been a key feature of health systems' response to ensuring people can access care in a safe manner during Covid-19. In many countries, including Ireland, telemedicine is a key form of accessing primary and hospital care (Banks et al, 2021;Greenhalgh et al, 2020;Homeniuk and Collins, 2021). In some systems, telemedicine technology has been linked to EHR systems to allow the monitoring of patients through a continuum of services (Ford et al, 2020).…”

“…Figure 4.3 presents the key findings from an analysis which examined increased use of telemedicine for outpatient department (OPD) care for people with epilepsy (Banks et al, 2021 Banks et al (2021) also found that the vast majority of clinicians who undertook the OPD consultations felt that the patient was appropriate for a virtual encounter (~90%), and they were happy that the patient could continue their routine care virtually (~75%) (Banks et al, 2021). In addition, the authors found that a majority of patients with epilepsy were happy to have their care provided virtually if their condition remained stable.…”

Epilepsy care and COVID‐19: A cross‐sectional online survey from Lithuania

“…2,3 While studies indicate that both persons with epilepsy (PWE) and epilepsy specialists are content with remote consultations, additional research is needed to determine its main benefits for the diagnostic and treatment process. [3][4][5] We investigated factors that will be relevant for a seamless transition to a post-pandemic world and may represent innovations of the patient-specialist interaction in epilepsy care.We report a nationwide cross-sectional online survey with focus on epilepsy care among members of the Lithuanian Association of Neurology. The aims of our study were to outline the experience of neurology specialists when providing services for PWE during the global COVID-19 pandemic, determine neurologists' views on vaccination against COVID-19 and telehealth.…”

“…2,3 While studies indicate that both persons with epilepsy (PWE) and epilepsy specialists are content with remote consultations, additional research is needed to determine its main benefits for the diagnostic and treatment process. [3][4][5] We investigated factors that will be relevant for a seamless transition to a post-pandemic world and may represent innovations of the patient-specialist interaction in epilepsy care.…”