Telemedicine utilization and patient satisfaction in an ambulatory movement disorders clinic during COVID-19

ABSTRACT

Objective: To compare patient satisfaction parameters with telehealth vs. in-person visits and trend telehealth utilization during the COVID-19 pandemic in the setting of an outpatient movement disorders clinic. Background: Preliminary studies suggest that patients are satisfied with telehealth in ambulatory settings during COVID-19. However, existing adult tele-neurology satisfaction data are limited by small sample size and exclusion of new patient encounters. Design/Methods: In this prospective observational cohort study, patients ≥18 years who completed an appointment at Northwestern's movement disorders clinic were invited to complete a post-encounter Medallia survey. The primary outcomes of the survey were likelihood to recommend (LTR) provider, LTR location, and 'spent enough time,' on a 0-10 scale. Responses were categorized into in-person vs. telehealth groups. Results: 621 patients responded to the Medallia survey (response rate = 30%), of which 365 had in-person encounters and 256 had telehealth. The two groups did not differ significantly in age and gender, however the percentage of new patient encounters was significantly higher with in-person visits compared to telehealth visits (25.2% vs. 4.7%;p-value < 0.001). No significant primary outcome differences were observed between in-person and telehealth encounters in LTR provider (p=0.892), LTR location (p=0.659), and time spent (p=0.395). Additional subgroup multivariable analysis did not support differences among age or gender. There was minimal utilization of telehealth prior to COVID-19 (0.3% vs. 39.5%, p-value < 0.001). Conclusions: With its large sample size, our study demonstrates that the utilization of telemedicine has increased dramatically in our movement disorders clinic during the coronavirus pandemic and patients report similar degrees of satisfaction with telehealth encounters compared to in-person encounters. Although limited by volunteer bias, our study supports the utility of telehealth in an ambulatory movement disorder setting. Further research is needed to compare the effectiveness of telehealth versus in-person encounters in other ambulatory neurology settings and using objective outcome measures.