key: cord-0981908-6rsh6zj4
authors: Wee, Diana; Li, Xiao; Suchman, Kelly; Trindade, Arvind J
title: Patient centered outcomes regarding telemedicine prior to endoscopy during the Coronavirus Disease 2019 pandemic
date: 2021-03-27
journal: Tech Innov Gastrointest Endosc
DOI: 10.1016/j.tige.2021.03.003
sha: 608224ac1bf5f4c0feaaad022165ab6ba0556ad6
doc_id: 981908
cord_uid: 6rsh6zj4

nan

In order to help understand patient satisfaction with telemedicine, we performed a quality improvement (QI) study that compared overall patient satisfaction among those who had advanced endoscopic pre-procedure consultation visits by telemedicine, traditional in-person visits, or a direct access procedure (instructions and procedure explained by a nurse practitioner or physicians assistant by phone).

Prior to COVID-19 our institution offered the latter two services. The study was determined to be exempt from the institutional board review. To assess satisfaction, we called a total of 322 consecutive patients who had undergone an advanced endoscopic procedure at our tertiary care center from May 2020 to August 2020 and asked them to complete a modified version of a validated patient satisfaction survey [4] ( Table 1 ). The survey was designed not only to assess overall patient satisfaction among the three groups, but also to assess patient satisfaction in their pre-procedure, intra-procedure, and post procedure experiences.

Of the 322 patients that were called, 123 agreed to participate (38%). The mean age was 60 +/-32 years. There were 26 (21%) who had in-person visits, 32 (26%) who had telemedicine visits, and 65 (52%) who had direct access procedures. The overall mean satisfaction scores among the three groups did not reveal a statistically significant difference (4.51 vs. 4.55 vs. 4.63, p=0.79). Sub-analysis of the preprocedure, intra-procedure, and post-procedure experiences did not show statistically significant differences among the three groups. ( 

To our knowledge, this is the first study to compare patient satisfaction among those who had advanced pre-procedure consultation by telemedicine visits, traditional in-person visits, or by a direct access procedure. We have found that there is no statistically significant difference in patient satisfaction among the three different visit modalities, suggesting that telemedicine could be an effective and widely used tool for these subgroup of patients.

There are several limitations to our study. As our data was collected retrospectively, it was difficult to determine how patients were selected for in-person pre-procedure visits, telemedicine pre-procedure visits, or direct access. However, it should be noted that most of our advanced pre-procedure visits proceed as direct access. If a patient requested to speak with a physician, then they are offered the choice of an in-person or telemedicine visit, suggesting the possibility of selection bias. Another limitation is the small sample size due to the low participation rate. This study calls for a prospective and larger study as telemedicine is increasingly being integrated into our healthcare delivery system. These findings show that telemedicine has an acceptable patient satisfaction rating, when counseling patients prior to endoscopy, compared to traditional consults and direct access care. It may also be superior to direct access care for patients with gastrointestinal cancers. In addition to patient satisfaction, telemedicine offers reduced traveling burden and safety of minimizing COVID-19 exposure during the ongoing pandemic .

Gastroenterology 2020 epub ahead of print

 4 . A score of 1 to 5 was assigned to each response (A=5, B=4, C =3, D=2 E=1) with 5 indicating the highest degree of satisfaction. For supplementary questions a score of 2 was assigned for an answer of yes and a score of 1 for an answer of no.