Telehealth is very convenient, and vital during a pandemic, but certain patients may be missing out.
Two new Australian studies have shown varying experiences with the use of telehealth during the covid pandemic, suggesting that careful patient selection is key to the successful integration of telemedicine.
A study conducted in two Adelaide-based hospital rheumatology outpatient departments – The Queen Elizabeth Hospital (TQEH) and the Royal Adelaide Hospital (RAH) – showed a varying range of patient satisfaction and acceptability of telehealth appointments across different demographics.
The onset of the covid pandemic saw both these hospitals move their rheumatology outpatient consultations to delivery by telehealth in early March 2020, and patients seen in March and April 2020 were invited to participate.
There were 128 responses, a 29% response rate, and the findings were published in Internal Medicine Journal in July.
The paper-based survey included 18 multiple-choice questions and four free-text questions and aimed to explore varying themes including health status, communication, accessibility, convenience, and confidentiality.
Most respondents (61.7%) agreed that they were generally satisfied with the current telemedicine system. Conversely, almost one-fifth of respondents were consistently dissatisfied with their telemedicine experience. These patients were older, lacked access to the internet and usually reported lower educational qualifications or health literacy scores.
Almost half (48.3%) of the respondents said they would continue to use telemedicine after the pandemic. Patients with disability and rural patients were more open to telemedicine post-covid. However, the authors noted that some other vulnerable populations, including those who need an interpreter, might not find added benefit with the use of telehealth.
Convenience was a major driving factor for patient acceptance of telemedicine, with telehealth previously inaccessible to urban communities for reasons including lack of consumer and clinician interest as well as lack of Medicare reimbursements. Both were remedied quickly in the pandemic.
In contrast, a significant number of respondents had negative experiences that they felt impacted their health, with health information anxiety and cognitive overload the major themes of concern.
Additionally, many respondents felt they were less involved in their care and management while engaging in telemedicine consultations, as well as being less likely to follow their doctor’s advice. Only 16% of respondents felt their health was better than before engaging in telemedicine.
One of the most significant findings was the recurring desire for a mixed-model consultation in the future, with patients opting for the flexibility of having both telehealth and in-person options.
Other studies in this field had different findings, including two studies that investigated patient satisfaction of telehealth in rural areas in 2015 and 2020. Satisfaction rates were 89% and 98% respectively.
The authors suggest urbanicity has a significant impact on this, with similar results found in international studies on telehealth.
Another recent study, a collaboration between the COVID-19 Global Rheumatology Alliance and the Australian Rheumatology Association Database (ARAD), looked at telehealth satisfaction rates among Australians with inflammatory arthritis. It was published in Internal Medicine Journal in May.
The researchers sent an online patient experience survey to 1583 ARAD participants and received 1032 responses, a 65% response rate. Almost 80% of respondents agreed that telehealth during the COVID-19 pandemic was acceptable. Of those, 82.2% also agreed that telehealth would continue to be acceptable after the pandemic.
The authors noted no significant demographic patterns in patient acceptability of telehealth, and almost all respondents thought their inflammatory arthritis healthcare had not been interrupted (85.6%) or compromised (89.5%) to a notable extent.
