Telemedicine Impact on the Patient-Provider Relationship in Primary Care During the COVID-19 Pandemic.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has necessitated a rapid uptake of telemedicine in primary care requiring both patients and providers to learn how to navigate care remotely. This change can impact the patient-provider relationship that often defines care, especially in primary care. OBJECTIVE: This study aims to provide insight into the experiences of patients and providers with telemedicine during the pandemic, and the impact it had on their relationship. RESEARCH DESIGN: A qualitative study using thematic analysis of semistructured interviews. SUBJECTS: Primary care providers (n=21) and adult patients (n=65) with chronic disease across primary care practices in 3 National Patient-centered Clinical Research Network sites in New York City, North Carolina, and Florida. MEASURES: Experiences with telemedicine during the COVID-19 pandemic in primary care. Codes related to the patient-provider relationship were analyzed for this study. RESULTS: A recurrent theme was the challenge telemedicine posed on rapport building and alliance. Patients felt that telemedicine affected provider's attentiveness in varying ways, whereas providers appreciated that telemedicine provided unique insight into patients' lives and living situations. Finally, both patients and providers described communication challenges. CONCLUSIONS: Telemedicine has altered structure and process aspects of primary health care such as the physical spaces of encounters, creating a new setting to which both patients and providers must adjust. It is important to recognize the opportunities and limits that this new technology has to help providers maintain the type of one-on-one attention that patients expect and that contributes to relationship building.