Dana-Farber Cancer Institute, Boston, MA
Kelly Eng, Caitlin C. Donohue, Andrew J. Wagner, David W. Dougherty, Elahi Salehi, Carol Lowenstein, Daniel A. Gundersen, Ruth Lederman, Sarah Kadish
Background: Due to COVID-19, telehealth volume at our comprehensive cancer center rose from less than 5% of exam visits to over 25% in April 2020. We sought to understand the experience of telehealth and compare it to in-person experiences for patients and providers (physicians, nurse practitioners, and physician assistants) to identify areas for improvement. Methods: A multidisciplinary team adapted our existing patient satisfaction survey to incorporate telehealth, defined as phone and video exam visits. A technology section was created to assess aspects unique to telehealth. Questions about the patient-provider experience were the same for telehealth and in-person visits. A provider experience survey was conducted during a two-week period in May and June 2020. The provider survey aligned questions with the patient survey to compare the perceptions of the provider-patient interaction. Results: Patient experience scores for in-person and telehealth visits were comparable, with a slightly higher mean score for in-person visits. The mean scores for patient perception of care given at our cancer center was 97.5 (n=11,969) and 96.9 (n=4670) and the likelihood to recommend was 97.8 (n=12,072) and 97.4 (n=4,398) for in-person and telehealth, respectively, between June and December 2020. Patient feedback prioritized addressing technical barriers. We implemented several interventions and increased the telehealth technology section mean scores from 93.2 (n=1,095) to 95.2 (n=700) between June and December 2020. When comparing the percent of respondents scoring good or very good, provider scores showed sizable gaps between in-person and telehealth experiences on all questions (see table). The question “degree to which the care team was well coordinated” had the largest difference between in-person and telehealth scores for both patients and providers. Several interventions to adapt staffing and workflows have been implemented to improve care telehealth coordination. Conclusions: While patients reported similar satisfaction between in-person and telehealth visits, increasing coordination remains vital to improving the experience for both patients and providers. Furthermore, understanding the gap in the provider experience between in-person and telehealth is critical for successful adoption of telehealth as a long-term strategy for healthcare delivery.
Question | % Responded Good or Very Good (n) | |||
---|---|---|---|---|
In-person Providers | In-person Patients | Telehealth Providers | Telehealth Patients | |
Overall quality of care received from provider | 97.9 (228) | 99.4 (639) | 91.0 (221) | 98.9 (543) |
Degree care was well coordinated among care team | 93.1 (216) | 98.0 (529) | 81.1 (198) | 96.4 (404) |
Provider ability to show concern for question/worries | 95.7 (223) | 98.9 (633) | 90.5 (219) | 98.6 (550) |
Provider ability to keep patient informed | 96.1 (223) | 98.4 (634) | 92.4 (220) | 97.8 (539) |
Amount of time provider spent with patient | 93.2 (215) | 98.9 (634) | 88.0 (213) | 98.4 (550) |
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