Telemedicine Implementation in Solid Organ Transplant (SOT) Clinics is Associated with Satisfaction Among Patients and Providers but Increased Burden on Staff

ABSTRACT

Purpose: Telemedicine is an essential part of healthcare delivery and has grown exponentially during the COVID-19 pandemic. Data on optimal utilization and implementation of telemedicine in SOT care remain limited. We aimed to evaluate patient, provider and clinic staff perspectives on telemedicine use and potential barriers in SOT clinics. Method(s) We prospectively enrolled adults seen via telemedicine (video or telephone) in SOT clinics at a single academic transplant center between 9-10/2021. Patients completed a survey administered either online or phone following their visit. Providers and clinic staff involved in telemedicine completed online surveys. Surveys were tailored to patient, provider and clinic staff to assess specific concerns, barriers and satisfaction with telemedicine. Result(s) Survey response rate was 21% (175/853) for patients, 57% (70/122) for providers and 31% (20/64) for clinic staff. 95% of visits were video and seen in liver (39%), kidney (40%), lung (16%) and heart transplant (5%) clinics. Patients were male (51%) with a median age of 62, English-speaking (95%) and had some college experience (84%). Patient and provider descriptions of telemedicine use are shown in Figure 1. Patients were not concerned with privacy (86%), lack of physical exam (76%), audio/video difficulties (89% and 93%) or help with setup (82%). Most were satisfied with the ease of video visit (85%) and quality of care (80%). Compared to in-person visits, patients felt their telemedicine visit was similar (66%) if not better (16%). Among providers, most were satisfied with ease of video visits (74%) and quality of care (60%), but 48% were dissatisfied with telephone visits. Providers spent time assisting patients (72%) or required help from staff to aid patients (7%) with visits;90% noted functioning of software/hardware before visits as crucial to improving telemedicine use. Among clinic staff, 50% reported additional time spent aiding patients with initial visit setup due to needing to instruct how to use telemedicine software (60%) and providing additional instructions to caregiver(s) (20%). Conclusion(s) Telemedicine via video is an effective and convenient method of healthcare delivery across the continuum of SOT care according to patients, providers and clinic staff. However, concerns about time assisting with setup were noted by providers and staff. Additional resources and support are needed to improve navigation of telemedicine for patients and to improve efficiency with telemedicine for providers and staff. (Figure Presented).