Patient and Provider Satisfaction With Telemedicine in Otolaryngology

Abstract

Objective The objective of this study is to evaluate patient and provider satisfaction with telemedicine encounters across 3 otolaryngology practices. Study Design Cross-sectional survey. Setting A military community hospital, an academic military hospital, and a nonmilitary academic center. Methods A telephone-based survey of patients undergoing telemedicine encounters for routine otolaryngology appointments was performed between April and July 2020. Patients were asked about their satisfaction, the factors affecting care, and demographic information. A provider survey was emailed to staff otolaryngologists. The survey asked about satisfaction, concerns for reimbursement or liability, encounters best suited for telemedicine, and demographic information. The results were analyzed with descriptive statistics and a multivariable logistic linear regression model to determine odds ratios. Results A total of 325 patients were surveyed, demonstrating high satisfaction with telemedicine (average score, 4.49 of 5 [best possible answer]). Patients perceived “no negative impact” or “minor negative impact” on the encounter due to the lack of a physical examination or face-to-face interaction (1.86 and 1.95 of 5, respectively). High satisfaction was consistent across groups for distance to travel, age, and reason for referral. A total of 25 providers were surveyed, with an average satisfaction score of 3.44 of 5. Providers reported “slight” to “somewhat” concern about reimbursement (40%) and liability (32%). Conclusion Given patients’ and providers’ levels of satisfaction, there is likely a role for telemedicine in otolaryngology practice that may benefit patient care independent of the COVID-19 pandemic.

A systematic review of outcomes of remote consultation in ENT

“…Two studies reported staff satisfaction, which was variable 67,68 . In one study using telephone in follow‐up, staff were either satisfied or ambivalent, expressing concerns on the impact of reimbursement as well as consequences of decision‐making without physical examination, on misdiagnosis and malpractice 68 .…”

“…Three studies reported use of telephone or the telemedicine platform SARA for remote follow‐up of general adult or paediatric ENT 66,67 68 . Two of these reported the proportion of patients requiring a subsequent F2F consultation was 10% (20/200) and 45% (45/100), 66,67 with reasons including need for physical examination, need for audiometry, or because of carer request.…”

“…66 Two studies reported staff satisfaction, which was variable. 67,68 In one study using telephone in follow-up, staff were either satisfied or ambivalent, expressing concerns on the impact of reimbursement as well as consequences of decision-making without physical examination, on misdiagnosis and malpractice. 68 Conversely, staff using the telemedicine platform SARA reported 100% satisfaction; with all reporting, they would continue to use the software although recognising it did not replace F2F review in some initial consultations or where audiometry may be required.…”

Patient’s point of view on the use of telemedicine in multiple sclerosis: a web-based survey

“…When possible, in-person visits were replaced by telephone visit or video visit, with different levels of doctors and patients' satisfaction, mostly depending on the type of visit (audio/video), patient's age, diagnosis, socioeconomic status, quality of the available technological devices, and presence of a caregiver [2][3][4][5][6][7][8][9][10].…”

The cell phone vibration test: A telemedicine substitute for the tuning fork test

“… 19 , 20 More recent studies found high levels of both patient and provider satisfaction with respect to tele‐otolaryngology, though there remains some concern regarding the lack of physical examination. 21 Virtual physical examination maneuvers help address this practice gap, but the most apparent barrier is the ability and confidence of the patient to perform a maneuver on themselves.…”