COMPARING PROVIDER AND PATIENT EXPERIENCES WITH TELEMEDICINE USE IN PRIMARY CARE: LEARNING FROM THE COVID-19 PANDEMIC

ABSTRACT

BACKGROUND: The COVID-19 pandemic has necessitated a rapid uptake of telemedicine in primary care. However, a comprehensive evaluation of such programs is currently lacking and there are substantial differences between telemedicine programs rolled out in different practices. We undertook this study to understand patients' and providers' experiences with telemedicine in primary care. METHODS: We conducted semi-structured interviews with primary care providers (n=21) and patients (n=65) with a chronic disease in three PCORnet sites in New York City, North Carolina and Florida. We specifically asked about barriers to and facilitators of, as well as benefits of and challenges with, telemedicine use. Three coders developed the code key and coded transcripts individually. Codes were compared and discrepancies resolved. Data was analyzed using interpretive description. RESULTS: Of the primary care providers, 62% were female and 9% selfi dentified as Black, 48% White, 24% Asian, 14% Hispanic and 5% Other. Of the patients, 60% were female and 25% self-identified as Black, 42% were White, 23% Hispanic, 1% Asian and 9% Other. Patients and providers both agreed that the benefits of telemedicine included increased convenience particularly for patients, eliminating travel hassle and time constraints. Primary challenges associated with telemedicine were the inability to do a physical exam, decreased patient-physician rapport and some concern about quality of care. Technology (internet difficulties, lack of access to video capability), lower technology literacy, complicated telemedicine platforms were seen as challenges to telemedicine use. Both patients and providers recommended more technological and ancillary support as well as increased education about telemedicine would facilitate telemedicine use. CONCLUSIONS: Patients and providers report several benefits of telemedicine during the COVID pandemic but telemedicine cannot fully replace in-person visits for a variety of reasons. Telemedicine can both exacerbate and ameliorate disparities in healthcare, and technology issues and improving technological and ancillary support may increase telemedicine use and reduce disparities in care.