Patient Satisfaction with In-Person, Video, and Telephone Allergy/Immunology Evaluations During the COVID-19 Pandemic

Abstract

Background The novel coronavirus (COVID-19) pandemic necessitated a rapid transition from in-person evaluations to remote delivery of care, including both video and telephone visits, in allergy/immunology practices. Objective To evaluate patient satisfaction, patient and physician impression of encounter completeness, and reimbursement between in-person, video, and telephone encounters. This study also assessed factors influencing patient satisfaction, perception of completeness, and choice of future evaluation type. Methods This was a prospective study of all encounters at a healthcare-system owned practice. Encounter type, encounter modality, patient demographics, primary diagnoses, reimbursement data, and physician assessment of encounter completeness were tracked. Patient satisfaction was assessed via standardized questions. Results There were 447 encounters, with 303 (67.8%) in-person, 98 (21.9%) video, and 46 (10.3%) telephone. Patient satisfaction data was obtained from 251 patients. There was similar patient satisfaction among all encounter modalities. Both patients and physicians were more likely to deem an in-person encounter as complete. Physicians were more likely to report an in-person encounter to be complete for food allergy (p<0.001) and chronic rhinitis (p=0.001) as compared to video or telephone, whereas patients reported in-person encounters for food allergy to be complete as compared to other modalities (p=0.002). Patients reported that future encounter types should depend on the clinical situation. Conclusions There was similar patient satisfaction with in-person, video, and telephone encounters in an allergy/immunology practice during the COVID-19 pandemic. Chronic rhinitis and food allergy are more likely to call for an in-person evaluation. New patient visits are likely to be the most high-yield to focus on for in-person evaluations.

Reliability of televisits for patients with mild relapsing–remitting multiple sclerosis in the COVID-19 era

“…On the other hand, when participants were asked to express their level of satisfaction with the use of TM to perform the follow-up neurological examinations, the overall level of satisfaction of both patients and caregivers was considerably high and only few patients declared their unwillingness to undergo further visits performed through TM. This agrees with results from other studies investigating the use of TM for patients with chronic diseases, confirming levels of satisfaction above 80% [ 25 ], although patients tend to consider in-person visits as more appropriate to discuss psychosocial and emotional issues[ 26 – 28 ].…”

Telemedicine in allergy/immunology in the era of COVID-19: a Canadian perspective

“…We were not able to record other medical comorbidities of the patients given the methodology of our QI initiative. This is in keeping with previous similar CIA virtual care patient satisfaction survey studies [ 1 , 5 – 8 , 17 ]. While our patient surveys were only sent to new consultation patients, Mustafa et al noted similar high rates of patient satisfaction between new and follow-up patients in their study [ 7 ].…”

“…We were not able to send surveys to all virtually-assessed patients and given the anonymized and randomization of the survey results, we are unable to know whether the respondents are an adequate representation of the general population. However, we believe the sample from our randomly sent surveys and comments are representative of overall perception of virtual care as our results are in keeping with similar studies [ 1 , 5 – 9 , 17 ]. We were not able to record other medical comorbidities of the patients given the methodology of our QI initiative.…”

Have the rules of engagement changed?

“…Telehealth visits can be as effective as in-person visits for many conditions routinely evaluated in the allergy office 3 , especially routine follow-up visits for non-pulmonary disease and as an option for unvaccinated patients during peak viral seasons. This could improve patient convenience and satisfaction but also potentially increase practice reach to areas that previously could not be served.…”