1Department of Neurosurgery, Baylor College of Medicine, Houston; and.
2Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas.
Neurosurg Focus. 2020 Dec;49(6):E13. doi: 10.3171/2020.9.FOCUS20596.
Telemedicine has rapidly expanded in the recent years as technologies have afforded healthcare practitioners the ability to diagnose and treat patients remotely. Due to the COVID-19 pandemic, nonessential clinical visits were greatly limited, and much of the outpatient neurosurgical practice at the authors' institution was shifted quickly to telehealth. Although there are prior data suggesting that the use of telemedicine is satisfactory in other surgical fields, data in neurosurgery are limited. This study aimed to investigate both patient and provider satisfaction with telemedicine and its strengths and limitations in outpatient neurosurgery visits.
This quality improvement study was designed to analyze provider and patient satisfaction with telemedicine consultations in an outpatient neurosurgery clinic setting at a tertiary care, large-volume, academic center. The authors designed an 11-question survey for neurosurgical providers and a 13-question survey for patients using both closed 5-point Likert scale responses and multiple choice responses. The questionnaires were administered to patients and providers during the period when the clinic restricted in-person visits. At the conclusion of the study, the overall data were analyzed qualitatively and quantitatively.
During the study period, 607 surveys were sent out to patients seen by telehealth at the authors' academic center, and 122 responses were received. For the provider survey, 85 surveys were sent out to providers at the authors' center and other academic centers, and 40 surveys were received. Ninety-two percent of patients agreed or strongly agreed that they were satisfied with that particular telehealth visit. Eighty-eight percent of patients agreed that their telehealth visit was more convenient for them than an in-person visit, but only 36% of patients stated they would like their future visits to be telehealth. Sixty-three percent of providers agreed that telehealth visits were more convenient for them than in-person visits, and 85% of responding providers stated that they wished to incorporate telehealth into their future practice.
Although the authors' transition to telehealth was both rapid and unexpected, most providers and patients reported positive experiences with their telemedicine visits and found telemedicine to be an effective form of ambulatory neurosurgical care. Not all patients preferred telemedicine visits over in-person visits, but the high satisfaction with telemedicine by both providers and patients is promising to the future expansion of telehealth in ambulatory neurosurgery.
随着技术的发展，医疗保健从业者能够远程诊断和治疗患者，远程医疗在近年来迅速发展。由于 COVID-19 大流行，非必要的临床就诊受到了极大限制，作者所在机构的大部分门诊神经外科业务迅速转向远程医疗。尽管有先前的数据表明，在其他外科领域使用远程医疗是令人满意的，但神经外科的数据有限。本研究旨在调查患者和提供者对远程医疗的满意度，以及其在门诊神经外科就诊中的优势和局限性。
本质量改进研究旨在分析在一家三级护理、大容量、学术中心的门诊神经外科诊所环境中，提供者和患者对远程医疗咨询的满意度。作者为神经外科医生设计了一份 11 个问题的调查问卷，为患者设计了一份 13 个问题的调查问卷，采用 5 分李克特量表和多项选择回答。在诊所限制亲自就诊期间，向患者和医生发放了问卷。在研究结束时，对整体数据进行了定性和定量分析。
在研究期间，向作者所在学术中心接受远程医疗的患者发送了 607 份调查问卷，收到了 122 份回复。对于医生调查问卷，向作者所在中心和其他学术中心的医生发送了 85 份调查问卷，收到了 40 份回复。92%的患者表示对特定的远程医疗就诊感到满意或非常满意。88%的患者认为他们的远程医疗就诊比亲自就诊更方便，但只有 36%的患者表示希望未来的就诊采用远程医疗。63%的医生认为远程医疗就诊比亲自就诊更方便，85%的医生表示希望将远程医疗纳入他们的未来实践。
尽管作者所在机构向远程医疗的过渡既迅速又意外，但大多数医生和患者都对他们的远程医疗就诊经历表示满意，并认为远程医疗是一种有效的门诊神经外科护理形式。并非所有患者都更喜欢远程医疗就诊而不是亲自就诊，但医生和患者对远程医疗的高度满意度预示着远程医疗在门诊神经外科的未来发展前景广阔。
