A Comparison of the Telemedicine Experience in the Early Pandemic (2020) Vs. Later Pandemic (2021) Periods: Results of a Mixed Methods Comparison
Kelly Pring1, Sharon Thomson2, Carly Olszewski3, Siobhan Cox1, Rebecca Merrill1, Emily Fishman1, Alexander Ambrosini4, Kevin Soltany1, Gabriella Bognet5, Lauren Strauss6, Rachel Graham6, Amy Guzik6, Roy Strowd6
1Wake Forest School of Medicine, 2Dartmouth Hitchcock Medical Center, 3UC San Diego, 4Yale School of Medicine, 5Wake Forest University, 6Wake Forest University Baptist Medical Center
Objective:
To compare patients’ telemedicine experience between the early and later pandemic.
Background:
At our institution, only telemedicine was used for ambulatory neurology care in 2020. By 2021, in-person, video, and telephone visits were available. Although 2020 and 2021 data were independently analyzed, here we compare changes in patient experiences over time.
Design/Methods:
In two prior studies, patients who completed ambulatory neurology visits in March 2020 and 2021 were contacted1-2; they completed a telephone satisfaction survey and semi-structured qualitative interview. In this study, responses were coded and stratified by visit type. Coded responses for video and telephone visits were combined. Themes in 2020 and 2021 were identified and compared.
Results:
38% of patients were contacted in 2020 vs. 51% in 2021; respondents were similar in mean age, race, and sex at both time points. Several themes emerged from comparison of qualitative data: normalization, personalization, positive implications, and limitations of telemedicine. Normalization: in 2021, patients were less concerned about logistical burdens, limitations of physical exam, and expressed more belief that telemedicine offers equivalent quality of care. Personalization: patients consistently reported telemedicine as optimal for medication management and low-acuity visits; new themes in 2021 were convenience for working-class, parents/caregivers, and students. Positive Implications: patients were dissatisfied with technology access in 2020; this was rare in 2021, indicating increased accessibility. In both 2020 and 2021 conveniences were cited including commute time, gasoline costs, parking costs, and inclement weather concerns. Limitations: concerns with administrative delays and perceptions of lower quality of care remained in 2021.
Conclusions:
As patient expectations evolved during the COVID-19 pandemic, telemedicine became the norm. It has been personalized to address needs of different patient populations. Continued application relies on maintaining patient convenience, safety, and trust while increasing accessibility by eliminating inequities, technology gaps, and patient-perceived differences in quality of care.