Telemedicine Here to Stay? Key Indicators to Patient Satisfaction

ABSTRACT

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic initiated rapid widespread utilization of telemedicine affecting all health care providers, including those in pediatric urology. Understanding the factors of patient and parent satisfaction can aid in health care delivery. The aim of this study was to identify key indicators of patient and parent satisfaction with pediatric urology telemedicine visits. METHOD(S) We conducted a prospective cross-sectional survey of all patients evaluated with a telehealth visit from October 2021 - April 2022. We included all consecutive patients aged 0-18 years who received an outpatient pediatric urology telehealth visit. All patients received an 8-question patient/parent reported outcome (PRO) survey via email within 30 days of the visit, including 5 satisfaction questions regarding various aspects of telemedicine rated on a scale of 1-5. Statistical analysis was performed using Pearson correlation, Mann- Whitney U, and Chi Squared tests, with p<0.05 considered significant. RESULT(S) A total of 1213 patients completed a telehealth visit, of which 83 (7%) completed the PRO survey. Visit type included 40 (48%) post-operative, 29 (35%) follow-up, and 14 (17%) new consults. From the survey responses, 84% reported time savings, 31% reported money savings, 30% avoided time away from work, and 27% of children avoided missing school. No technical issues were experienced in 86% of the visits. Satisfaction with telehealth was highest for the post-operative patient, 4.8/5 after orchiopexy and 4.4/5 after circumcision. Patients saved a median travel distance of 22 miles [IQR 15-41]. Patients living farther than 22 miles had higher satisfaction scores in terms of simplicity and preference to in-person visits compared to those who lived closer (p=0.019). Patients living in zip codes below the median household income had significantly higher satisfaction scores (p =0.032). Patients with public health insurance had significantly higher overall satisfaction scores compared to those with private health insurance (p=0.022). There was no difference in satisfaction based on parent age or whether the patient was evaluated for a new, follow-up, or post-operative video visit. CONCLUSION(S) Children and their caregivers were satisfied with pediatric urology telehealth visits when seen as a new, follow-up, or post-operative patient. Indicators for satisfaction may include long travel distance to the clinic, lower than median household income zip codes, and public health insurance. Appropriate use of telehealth may provide better access to care and optimize healthcare delivery.