Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New York, USA.
Telemed J E Health. 2022 Feb;28(2):150-157. doi: 10.1089/tmj.2021.0060. Epub 2021 May 7.
The coronavirus disease 2019 (COVID-19) heralded an unprecedented increase in telemedicine utilization. Our objective was to assess patient satisfaction with telemedicine during the COVID-19 era. Telemedicine visit data were gathered from Stanford Health Care (Stanford) and the Hospital for Special Surgery (HSS). Patient satisfaction data from HSS were captured from a Press-Ganey questionnaire between April 19, 2020, and December 12, 2020, whereas Stanford data were taken from a novel survey instrument that was distributed to all patients between June 22, 2020, and November 1, 2020. There were 60,550 telemedicine visits at Stanford, each linked with a postvisit survey. At HSS, there were 66,349 total telemedicine visits with 7,348 randomly linked with a postvisit survey. Two measures of patient satisfaction were used for this study: (1) a patient's "overall visit score" and (2) whether the patient indicated the highest possible "likelihood to recommend" (LTR) score (LTR top box score). The LTR top box percentage at Stanford increased from 69.6% to 74.0% ( = 0.0002), and HSS showed no significant change (p = 0.7067). In the multivariable model, the use of a cell phone (adjusted odds ratio [aOR]: 1.18; 95% confidence interval [CI]: 1.12-1.23) and tablet (aOR: 1.15; 95% CI: 1.07-1.23) was associated with higher overall scores, whereas visits with interrupted connections (aOR: 0.49; 95% CI: 0.42-0.57) or help required to connect (aOR: 0.49; 95% CI: 0.42-0.56) predicted lower patient satisfaction. We present the largest published description of patient satisfaction with telemedicine, and we identify important telemedicine-specific factors that predict increased overall visit score. These include the use of cell phones or tablets, phone reminders, and connecting before the visit was scheduled to begin. Visits with poor connectivity, extended wait times, or difficulty being seen, examined, or understood by the provider were linked with reduced odds of high scores. Our results suggest that attention to connectivity and audio/visual definition will help optimize patient satisfaction with future telemedicine encounters.
新型冠状病毒病 2019（COVID-19）的出现导致远程医疗的利用空前增加。我们的目的是评估 COVID-19 期间远程医疗的患者满意度。斯坦福健康医疗中心（斯坦福）和特殊外科医院（HSS）收集了远程医疗就诊数据。HSS 的患者满意度数据是从 2020 年 4 月 19 日至 2020 年 12 月 12 日期间的 Press-Ganey 问卷调查中获取的，而斯坦福的数据则来自于 2020 年 6 月 22 日至 2020 年 11 月 1 日期间向所有患者分发的新调查工具。斯坦福有 60550 次远程医疗就诊，每次就诊后都进行了调查。HSS 共有 66349 次远程医疗就诊，其中 7348 次随机与就诊后调查相关联。本研究使用了两种患者满意度衡量标准：（1）患者的“整体就诊评分”和（2）患者是否表示了最高的“推荐可能性”（LTR）评分（LTR 最高分）。斯坦福的 LTR 最高分百分比从 69.6%增加到 74.0%（=0.0002），而 HSS 没有显著变化（p=0.7067）。在多变量模型中，使用手机（调整后的优势比[aOR]：1.18；95%置信区间[CI]：1.12-1.23）和平板电脑（aOR：1.15；95%CI：1.07-1.23）与更高的整体评分相关，而连接中断（aOR：0.49；95%CI：0.42-0.57）或需要帮助才能连接（aOR：0.49；95%CI：0.42-0.56）的就诊预测患者满意度较低。我们提出了迄今为止发表的关于远程医疗患者满意度的最大描述，并确定了预测整体就诊评分提高的重要远程医疗特定因素。这些因素包括使用手机或平板电脑、电话提醒以及在预约开始前进行连接。连接质量差、等待时间延长或难以与提供者进行沟通、检查或理解的就诊，其获得高分的可能性较低。我们的研究结果表明，关注连接和音频/视频清晰度将有助于优化未来远程医疗就诊的患者满意度。
