Elliott Tania, Tong Ian, Sheridan Arwen, Lown Beth A
NYU Langone Health, New York, NY.
Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Mayo Clin Proc Innov Qual Outcomes. 2020 Jun 5;4(3):305-314. doi: 10.1016/j.mayocpiqo.2020.04.009. eCollection 2020 Jun.
To understand the interpersonal and communication behaviors that are perceived positively by patients in a video encounter and whether patient-centered relationships can be established virtually.
A qualitative analysis of patient visit feedback was performed to build consensus around exemplary interpersonal and communication practices during a virtual urgent care visit. Voluntarily submitted patient comments associated with a 5-star review after a visit were randomly selected from more than 49,000 comments in an 11-month period, from January 1, 2016, through November 30, 2016. Researchers used a consensus-based, widely used health care communications framework as a sensitizing scaffold to develop a preliminary set of codes.
More than 30% of the comments coded were classified as Building Rapport. The next most frequently assigned code was Shares Information/Provides Guidance. Among codable comments, the third most frequently assigned code was Elicits Information. Provided Treatment accounted for only 2% of comments.
These results suggest that patients who are satisfied with telemedicine encounters appreciate their relational experiences with the clinician and overall user experience, including access and convenience. Highly satisfied patients who interacted with providers on this platform commented on key aspects of medical communication, particularly skills that demonstrate patient-centered relationship building. This supports the notion that clinician-patient relationships can be established in a video-first model, without a previous in-person encounter, and that positive ratings do not seem to be focused solely on prescription receipt.
了解患者在视频问诊中认为积极的人际和沟通行为,以及是否可以通过虚拟方式建立以患者为中心的关系。
对患者就诊反馈进行定性分析,以围绕虚拟紧急护理就诊期间的模范人际和沟通实践达成共识。从2016年1月1日至2016年11月30日这11个月内的49000多条评论中随机选取就诊后自愿提交的与五星级评价相关的患者评论。研究人员使用基于共识的、广泛使用的医疗保健沟通框架作为敏感支架来制定初步的编码集。
超过30%的编码评论被归类为建立融洽关系。其次最常分配的编码是分享信息/提供指导。在可编码的评论中,第三最常分配的编码是引出信息。提供治疗仅占评论的2%。
这些结果表明,对远程医疗问诊满意的患者重视他们与临床医生的关系体验和整体用户体验,包括可及性和便利性。在该平台上与提供者互动的高度满意的患者对医疗沟通的关键方面发表了评论,特别是展示以患者为中心的关系建立的技能。这支持了这样一种观点,即医患关系可以在以视频为先的模式中建立,无需先前的面对面接触,而且积极的评分似乎并不完全集中在收到处方上。