Dainty Katie N, Seaton M Bianca, Estacio Antonio, Hicks Lisa K, Jamieson Trevor, Ward Sarah, Yu Catherine H, Mosko Jeffrey D, Kassardjian Charles D
North York General Hospital, Toronto, ON, Canada.
St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
JMIR Med Inform. 2022 Jun 28;10(6):e37196. doi: 10.2196/37196.
Transitioning nonemergency, ambulatory medical care to virtual visits in light of the COVID-19 global pandemic has been a massive shift in philosophy and practice that naturally came with a steep learning curve for patients, physicians, and clinic administrators.
We undertook a multimethod study to understand the key factors associated with successful and less successful experiences of virtual specialist care, particularly as they relate to the patient experience of care.
This study was designed as a multimethod patient experience study using survey methods, descriptive qualitative interview methodology, and administrative virtual care data collected by the hospital decision support team. Six specialty departments participated in the study (endoscopy, orthopedics, neurology, hematology, rheumatology, and gastroenterology). All patients who could speak and read English and attended a virtual specialist appointment in a participating clinic at St. Michael's Hospital (Toronto, Ontario, Canada) between October 1, 2020, and January 30, 2021, were eligible to participate.
During the study period, 51,702 virtual specialist visits were conducted in the departments that participated in the study. Of those, 96% were conducted by telephone and 4% by video. In both the survey and interview data, there was an overall consensus that virtual care is a satisfying alternative to in-person care, with benefits such as reduced travel, cost, time, and SARS-CoV-2 exposure, and increased convenience. Our analysis further revealed that the specific reason for the visit and the nature and status of the medical condition are important considerations in terms of guidance on where virtual care is most effective. Technology issues were not reported as a major challenge in our data, given that the majority of "virtual" visits reported by our participants were conducted by telephone, which is an important distinction. Despite the positive value of virtual care discussed by the majority of interview participants, 50% of the survey respondents still indicated they would prefer to see their physician in person.
Patient experience data collected in this study indicate a high level of satisfaction with virtual specialty care, but also signal that there are nuances to be considered to ensure it is an appropriate and sustainable part of the standard of care.
鉴于新冠疫情全球大流行，将非紧急门诊医疗服务转变为虚拟问诊是理念和实践上的巨大转变，患者、医生和诊所管理人员自然都面临着陡峭的学习曲线。
我们开展了一项多方法研究，以了解与虚拟专科护理成功和不太成功体验相关的关键因素，特别是与患者护理体验相关的因素。
本研究设计为一项多方法患者体验研究，采用调查方法、描述性定性访谈方法以及医院决策支持团队收集的行政虚拟护理数据。六个专科部门参与了该研究（内窥镜检查、骨科、神经科、血液科、风湿病科和胃肠病科）。所有能说英语和阅读英语、于2020年10月1日至2021年1月30日期间在加拿大多伦多圣迈克尔医院参与研究的诊所进行虚拟专科预约的患者均有资格参与。
在研究期间，参与研究的部门共进行了51702次虚拟专科问诊。其中，96%通过电话进行，4%通过视频进行。在调查和访谈数据中，总体共识是虚拟护理是面对面护理的一种令人满意的替代方式，具有减少出行、成本、时间以及接触新冠病毒的风险，且增加便利性等益处。我们的分析进一步表明，就诊的具体原因以及病情的性质和状况是指导虚拟护理最有效的关键考虑因素。鉴于我们的参与者报告的大多数“虚拟”问诊是通过电话进行的，这是一个重要区别，因此技术问题在我们的数据中并未被报告为主要挑战。尽管大多数访谈参与者讨论了虚拟护理的积极价值，但50%的调查受访者仍表示他们更愿意亲自看医生。
本研究收集的患者体验数据表明对虚拟专科护理满意度较高，但也表明需要考虑一些细微差别，以确保它是护理标准中合适且可持续的一部分。
