Pivot to telehealth: Preference for telehealth measured quantitatively sustained over three months at outpatient center for integrative medicine

ABSTRACT

Objective: Interdisciplinary integrative medicine is key to treatment of chronic pain conditions. In-person visits can burden this population, particularly in rural and underserved areas with limited transportation options. Telehealth visits, were historically unsupported by payment models, delivery platforms, health and technological literacy, and clinician buy-in. The COVID-19 pandemic initiated a rapid transition to telehealth at our interdisciplinary outpatient integrative medicine center. This poster will describe the quantitative experience of telehealth integrative medicine services among stakeholders. Methods: Patients (n=472), clinicians (n=25), and staff (n=12) ranked telehealth vs in-person visits by survey with custom scale quality judgments and discrete choice after transitioning to telehealth and three months later. Results: Patient quality judgements significantly favored telehealth at baseline, B=.77 [0.29-1.25], SE=.25, t(712)= 3.15, p=.002, and increased in preference for telehealth at three months, B=.27 [-0.03-0.57], SE=.15, t(712)= 1.76, p=.079. Quality of technology, residing outside the county, and experiencing multiple disciplines predicted patient telehealth favorability. Clinicians did not favor one modality over the other, B=-1.00 [-1.56--0.44], SE=.29, t(799)=-3.48, p<.001. Patient discrete choice split at baseline and favored telehealth at three months. Overall, discrete choice favored telehealth at follow-up across clinicians and patients. Administrative staff's overall impression of telehealth was most favorable of all groups. Conclusion: Telehealth is a promising care modality for patients experiencing chronic pain. Far from a temporary preference, after three months, the majority of patients indicated they would choose telehealth visits over inperson visits, if they were equally safe. Policy that does not support telehealth for outpatient integrative medicine cannot do so under the name of patient preference, perceptions of quality, patient choice, or access.