Patients value convenience of telemedicine

By Lisa Rapaport (Reuters Health) - Patients who have real-time video visits with their primary care providers instead of in-person exams are generally satisfied with the convenience and quality of their checkups, a new study suggests. There's a lot about these telemedicine visits that can sound appealing: no need to get stuck in traffic on the way to the doctor; no long stretches in the waiting room before the exam; no missing half a day of work for an appointment that's over in the blink of an eye. But research to date hasn't offered a clear picture of how the reality of virtual visits matches up with patients' expectations "Prior to the current study there was very little research evidence about primary-care video visits, especially when the visits are with a patient's own primary care providers (the ones they also visit in-person) as a part of their ongoing clinical care," said lead study author Dr. Mary Reed of Kaiser Permanente Northern California. Reed and colleagues surveyed 1,274 patients at Kaiser in Northern California who had a scheduled video visit with a primary care provider in autumn 2015 to see how well the technology and the medical care worked for them. Nearly all of the participants had some previous experience using video calling, although it might have been for personal or professional meetings and not for a medical checkup. Most of them also had undergraduate or advanced degrees and more than a third had household income of more than $100,000 a year. Patients who had to take time off from work or other responsibilities for an in-person visit reported more often that the video visit reduced their in-person visits. There were many reasons patients cited for having video visits: 87 percent found it more convenient; 82 percent liked that they could have the video visit with their regular primary care provider; and 70 percent were not sure they needed to go see a doctor in person. After the video exams, 93 percent of patients felt the checkup met their needs; 92 percent felt the provider was familiar with their medical history; and 90 percent were confident in the quality of their care. In addition, 84 percent of patients who had video visits thought the experience improved their relationship with their provider. However, 41 percent of participants said they preferred an in-person visit, 24 percent expressed concern about making their home or video visit space presentable for the checkup, and 21 percent of patients worried they might not get adequate treatment. Overall, however, nine in ten patients said they would consider a video visit in the future, even if they didn't go to their scheduled visit during the study. One drawback of the study is that it's old - the video visits happened several years ago and technology used in 2015 may look a lot different than what's possible today. Patients in the study were also fairly affluent and educated, and it's possible results would look different for people with lower income and education levels. There's also a limit to what types of medical conditions may be suitable for telemedicine checkups, said Dr. Jay Portnoy, medical director of telemedicine at Children's Mercy Hospital in Kansas City, Missouri. "The most common issues dealt with include colds, rashes, behavior issues and common issues that are embarrassing such as hair loss, erectile dysfunction, birth control and so on," Portnoy, who wasn't involved in the study, said by email. Video visits still might one day replace many in-person checkups, said Dr. Michael Barnett of the Harvard T. H. Chan School of Public Health in Boston. "We are a long way from that because many people prefer in-person care and technology is still a barrier for many of the sickest patients who don't use the internet or smart phones," Barnett, who wasn't involved in the study, said by email. "Video visits might help health spending by avoiding unnecessary office visits, but even if they don't the convenience and time saved from them is very valuable." SOURCE: Annals of Internal Medicine, online April 29, 2019.