Synchronous teleconsultation and monitoring service targeting COVID-19: leveraging insights for post-pandemic healthcare (Preprint)

Abstract

BACKGROUND Although a great number of teleconsultation services have been developed during COVID-19 pandemic, studies assessing usability and healthcare provider satisfaction are still incipient. OBJECTIVE To describe the development, implementation and expansion of a synchronous teleconsultation service targeting patients with symptoms of COVID-19 in Brazil, as well as to assess its usability and healthcare professionals’ satisfaction. METHODS This mixed-methods study was developed in five phases: (i) identification of components, technical and functional requirements and system architecture; (ii) system and user interface development and validation; (iii) pilot testing in the city of Divinópolis; (iv) expansion in the cities of Divinópolis, Teófilo Otoni and Belo Horizonte for Universidade Federal de Minas Gerais faculty and students; (v) usability and satisfaction assessment, using Likert scale and open-ended questions. RESULTS During pilot development, problems to contact users were solved by introducing standardized text messages (SMS) sent to them to obtain their feedback and keep track of them. Until July 31, 2021, the expanded system achieved 11,580 patients in 102,687 teleconsultations. Teleconsultations were initiated through chatbot in 15.8% of teleconsultations. Teleconsultation efficiency per city was 93.8% in Teófilo Otoni, 92.1% in Divinopolis, and 98.2% in Belo Horizonte (university campus), avoiding in-person assistance for the great majority of patients. 60 healthcare professionals assessed the system's usability as satisfactory, despite a few system instability problems. CONCLUSIONS The system provided updated information about COVID-19 and enabled remote care for thousands of patients, which evidenced the critical role of telemedicine in expanding emergency services capacity during the pandemic. The dynamic nature of the current pandemic required fast planning, implementation, development and updates in the system. Usability and satisfaction assessment was key to identifying areas for improvement. The experience reported here is expected to inform telemedicine strategies to be implemented in a post-pandemic scenario.