James Justin G, Park Jane, Oliver Alexandria, Xie Sharon X, Siderowf Andrew, Spindler Meredith, Wechsler Lawrence R, Tropea Thomas F
Department of Neurology (JGJ, JP, AO, AS, MS, LRW, TFT), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; CW Psychological Services (JP), King of Prussia, PA; and Department of Biostatistics (SXX), Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Neurol Clin Pract. 2023 Jun;13(3):e200159. doi: 10.1212/CPJ.0000000000200159. Epub 2023 May 1.
Teleneurology is common in clinical practice partly due to the SARS CoV-2 pandemic. Impressions about teleneurology from patients and providers alike are generally favorable; some of the reported benefits include ease of access to specialized health care, savings of time and money, and similar quality of care as an in-person visit. However, comparisons between patient and provider impressions about the same teleneurology encounter have not been described. In this study, we describe patient impressions about a teleneurology encounter and evaluate concordance with provider impressions about the same encounter.
Patients and providers at the University of Pennsylvania Hospital Neurology Department were surveyed about their impressions of teleneurology between April 27, 2020, and June 16, 2020. A convenience sample of patients, whose providers completed a questionnaire, were contacted by telephone to solicit their impressions about the same encounter. Unique questionnaires for patients and providers focused on similar themes, such as adequacy of technology, assessment of history obtained, and overall quality of the visit. Summaries of patient responses are reported with the raw percent agreement between patients and providers for similar questions.
One hundred thirty-seven patients completed the survey; 64 (47%) were male and 73 (53%) were female. Sixty-six (47%) patients had a primary diagnosis of PD, 42 (30%) a non-PD/parkinsonism movement disorder, and 29 (21%) a nonmovement disorder neurologic disease. One hundred one (76%) were established patient visits and 36 (26%) were new patient visits. Provider responses from 8 different physicians were included. Most of the patients responded that the ease of joining their visit, their comfort engaging with their physicians during their visit, understanding their plan of care after their visit, and the quality of care from their teleneurology visit were satisfactory. Patients and providers agreed about their impressions of the quality of the history obtained (87% agreement), patient-provider relationship (88% agreement), and overall quality of their experience (70% agreement).
Patients had favorable impressions about their clinical experience with teleneurology and expressed an interest in incorporating telemedicine visits into their ongoing care. Patients and providers were highly concordant for the history obtained, patient-provider relationship, and overall quality.
远程神经病学在临床实践中很常见,部分原因是新型冠状病毒肺炎疫情。患者和医疗服务提供者对远程神经病学的印象总体上是积极的;报告的一些益处包括便于获得专科医疗服务、节省时间和金钱,以及与面对面就诊具有相似的医疗质量。然而,尚未描述患者和医疗服务提供者对同一次远程神经病学诊疗的印象之间的比较情况。在本研究中,我们描述了患者对远程神经病学诊疗的印象,并评估了与医疗服务提供者对同一次诊疗的印象的一致性。
对宾夕法尼亚大学医院神经科的患者和医疗服务提供者进行了调查,询问他们在2020年4月27日至2020年6月16日期间对远程神经病学的印象。通过电话联系了其医疗服务提供者已完成问卷的患者便利样本,以征求他们对同一次诊疗的印象。患者和医疗服务提供者的独特问卷侧重于相似的主题,如技术的充分性、所获取病史的评估以及诊疗的总体质量。报告了患者回答的摘要以及患者和医疗服务提供者对相似问题的原始百分比一致性。
137名患者完成了调查;64名(47%)为男性,73名(53%)为女性。66名(47%)患者的主要诊断为帕金森病,42名(30%)为非帕金森病/帕金森综合征运动障碍,29名(21%)为非运动障碍性神经系统疾病。101名(76%)为复诊患者,36名(26%)为初诊患者。纳入了8位不同医生的医疗服务提供者回复。大多数患者表示,参加诊疗的便利性、诊疗期间与医生交流的舒适度、诊疗后对治疗计划的理解以及远程神经病学诊疗的医疗质量都令人满意。患者和医疗服务提供者对所获取病史的质量(一致性为87%)、医患关系(一致性为88%)以及总体体验质量(一致性为70%)的印象达成了一致。
患者对其远程神经病学临床体验有良好印象,并表示有兴趣将远程医疗诊疗纳入其持续治疗中。患者和医疗服务提供者在所获取病史、医患关系以及总体质量方面高度一致。