Howard S Gordon1,2,3, Pooja Solanki4, Barbara G Bokhour5,6, Ravi K Gopal7,8. 1. Jesse Brown Veterans Affairs Medical Center and VA Center of Innovation for Complex Chronic Healthcare, Chicago, IL, USA. hsg@uic.edu. 2. Section of Academic Internal Medicine, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA. hsg@uic.edu. 3. Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA. hsg@uic.edu. 4. Jesse Brown Veterans Affairs Medical Center and VA Center of Innovation for Complex Chronic Healthcare, Chicago, IL, USA. 5. Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Affairs Medical Center, Bedford, MA, USA. 6. Department of Health Law, Policy & Management, Boston University School of Public Health, Bedford, MA, USA. 7. Center of Innovation for Veteran-Centered & Value-Driven Care, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA. 8. Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Abstract
BACKGROUND: Clinical video telehealth (CVT) offers the opportunity to improve access to healthcare providers in medically underserved areas. However, because CVT encounters are mediated through technology, they may result in unintended consequences related to the patient-provider interaction. METHODS: Twenty-seven patients with type 2 diabetes mellitus enrolled in Veteran Affairs Health Care and at least one previous telehealth visit experience were interviewed regarding their perspectives on facilitators and barriers to communication with their provider during their CVT visit. The semi-structured telephone interviews were approximately 30 min and were audio-recorded and transcribed. We conducted a thematic content analysis of the interview transcripts. Codes from the transcripts were grouped into thematic categories using the constant comparison method and each theme is represented with illustrative quotes. RESULTS: We identified several themes related to patients' perspectives on CVT. In general, patients expressed satisfaction with CVT visits including better access to appointments, shorter travel time, and less time in the waiting room. Yet, patients also identified several challenges and concerns about CVT visits compared with in-person visits, including concerns about errors in their care because of perceived difficulty completing the physical exam, perceptions that providers paid less attention to them, barriers to speaking up and asking questions, and difficulty establishing a provider-patient relationship. Patients reported feeling less involved during the visit, difficulty finding opportunities to speak, and feeling rushed by the provider. CONCLUSIONS: Patients believed that CVT can improve their access to care, but could hinder communication with their provider, and some were concerned about the completeness and accuracy of the physical exam.
BACKGROUND: Clinical video telehealth (CVT) offers the opportunity to improve access to healthcare providers in medically underserved areas. However, because CVT encounters are mediated through technology, they may result in unintended consequences related to the patient-provider interaction. METHODS: Twenty-seven patients with type 2 diabetes mellitus enrolled in Veteran Affairs Health Care and at least one previous telehealth visit experience were interviewed regarding their perspectives on facilitators and barriers to communication with their provider during their CVT visit. The semi-structured telephone interviews were approximately 30 min and were audio-recorded and transcribed. We conducted a thematic content analysis of the interview transcripts. Codes from the transcripts were grouped into thematic categories using the constant comparison method and each theme is represented with illustrative quotes. RESULTS: We identified several themes related to patients' perspectives on CVT. In general, patients expressed satisfaction with CVT visits including better access to appointments, shorter travel time, and less time in the waiting room. Yet, patients also identified several challenges and concerns about CVT visits compared with in-person visits, including concerns about errors in their care because of perceived difficulty completing the physical exam, perceptions that providers paid less attention to them, barriers to speaking up and asking questions, and difficulty establishing a provider-patient relationship. Patients reported feeling less involved during the visit, difficulty finding opportunities to speak, and feeling rushed by the provider. CONCLUSIONS:Patients believed that CVT can improve their access to care, but could hinder communication with their provider, and some were concerned about the completeness and accuracy of the physical exam.
Entities:
Keywords:
patient-centered care; qualitative research; video telehealth
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