Overholt Tyler L, Dutta Rahul, Smith Whitney R, Velet Liliya P, Xu Raymond, Matthews Catherine A
From the Department of Urology.
Urogynecology (Phila). 2022 Sep 1;28(9):567-573. doi: 10.1097/SPV.0000000000001211. Epub 2022 May 30.
The COVID-19 pandemic prompted telemedicine adoption. In March 2020, we developed an implementation toolkit with a nursing protocol for patient preparation before tertiary care urology clinic visits.
Our primary objective was to determine patient satisfaction after implementation of a telemedicine toolkit. Our secondary objective was to assess downstream productivity generated from telehealth visits.
We prospectively conducted a postvisit survey that included the Telehealth Usability Questionnaire, a validated survey assessing patient satisfaction, for all patients with documented completion of the nursing protocol to assess patient experience and satisfaction. We then performed a retrospective chart review of all telemedicine visits to determine downstream outcomes, including imaging and procedure scheduling.
Between April and May 2020, 1,422 visits were completed, of which 265 had complete nursing protocol documentation. Eighteen of 265 (6.8%) reported setup assistance. Four (1.8%) were unsuccessful and converted to a nonvisual phone visit. Overall, 186 (70.1%) completed the Telehealth Usability Questionnaire with a mean score of 118.31 ± 23.44. High satisfaction was reported regardless of race, marital status, income, education, employment status, or travel distance. Younger age ( P = 0.017) and female sex ( P = 0.017) were associated with greater satisfaction. Of 1,422 total visits, imaging was ordered in 29%, office procedures scheduled in 14%, and surgery scheduled in 14%. New visits were more likely to result in procedure and surgery scheduling than returns ( P < 0.0001).
Our telemedicine toolkit designed to maximize patient engagement was successful in achieving patient-provider connectivity in 98% of patients with high satisfaction. Telemedicine visits are effective to provide comprehensive urologic care with implications beyond the pandemic.
2019冠状病毒病大流行促使远程医疗的采用。2020年3月,我们开发了一个实施工具包,并制定了一份护理方案,用于在三级护理泌尿外科门诊就诊前对患者进行准备。
我们的主要目标是确定远程医疗工具包实施后的患者满意度。我们的次要目标是评估远程医疗就诊产生的后续生产力。
我们前瞻性地进行了一次就诊后调查,该调查包括远程医疗可用性问卷,这是一份经过验证的评估患者满意度的调查问卷,适用于所有有护理方案完成记录的患者,以评估患者的体验和满意度。然后,我们对所有远程医疗就诊进行了回顾性病历审查,以确定后续结果,包括影像检查和手术安排。
在2020年4月至5月期间,共完成了1422次就诊,其中265次有完整的护理方案记录。265名患者中有18名(6.8%)报告得到了设置协助。4名(1.8%)患者就诊未成功,改为非视频电话就诊。总体而言,186名(70.1%)患者完成了远程医疗可用性问卷,平均得分为118.31±23.44。无论种族、婚姻状况、收入、教育程度、就业状况或旅行距离如何,患者均报告了较高的满意度。年龄较小(P=0.017)和女性(P=0.017)与更高的满意度相关。在总共1422次就诊中,29%的患者被安排进行影像检查,14%的患者被安排进行门诊手术,14%的患者被安排进行手术。新就诊患者比复诊患者更有可能被安排进行手术和安排手术时间(P<0.0001)。
我们设计的旨在最大限度提高患者参与度的远程医疗工具包成功地实现了98%的患者与医护人员的连接,患者满意度很高。远程医疗就诊有效地提供了全面的泌尿外科护理,其影响超出了大流行范围。