BACKGROUND AND PURPOSE: Telestroke has been demonstrated to be a cost-effective means to expand access to care and improve outcomes in stroke; however, information on patient perceptions of this system of care delivery are limited. This study seeks to examine patient feedback of a national telestroke system within the Veterans Health Administration. METHODS: Patients who received a telestroke consultation were eligible for a phone interview 2 weeks later, including questions about technology quality, telepresence, and telestroke provider communication. Satisfaction scores ranged from 1 to 7 (higher=more satisfied) and for analyses were dichotomized as 6 to 7 indicating high satisfaction versus <6. Patient variables including stroke severity (measured by the National Institutes of Health Stroke Scale) were obtained from study records. Generalized estimating equation models were used to determine what factors were associated with patient satisfaction. RESULTS: Over 18 months, 186 interviews were completed, and 142 (76%) reported high satisfaction with telestroke. Patients with more severe stroke were less likely to recall the consultation. Factors significantly associated with patient satisfaction were higher ratings of the technology (P<0.0001), telepresence (P<0.0001), provider communication ratings (P<0.0001), and overall Veterans Affairs satisfaction (P=0.02). In the multivariate model, telepresence (odds ratio, 3.10 [95% CI, 1.81-5.31]) and provider ratings (odds ratio, 2.37 [95% CI, 1.20-4.68]) were independently associated with satisfaction. Veterans who were satisfied were more likely to recommend the technology (P<0.0001). CONCLUSIONS: Provider qualities, including telepresence and provider ratings, were associated with overall Veteran satisfaction with the telestroke consultation. Technology quality may be necessary but not sufficient to impact patient experience. Training providers to improve telepresence could improve patient experience with telestroke consultation.
BACKGROUND AND PURPOSE: Telestroke has been demonstrated to be a cost-effective means to expand access to care and improve outcomes in stroke; however, information on patient perceptions of this system of care delivery are limited. This study seeks to examine patient feedback of a national telestroke system within the Veterans Health Administration. METHODS: Patients who received a telestroke consultation were eligible for a phone interview 2 weeks later, including questions about technology quality, telepresence, and telestroke provider communication. Satisfaction scores ranged from 1 to 7 (higher=more satisfied) and for analyses were dichotomized as 6 to 7 indicating high satisfaction versus <6. Patient variables including stroke severity (measured by the National Institutes of Health Stroke Scale) were obtained from study records. Generalized estimating equation models were used to determine what factors were associated with patient satisfaction. RESULTS: Over 18 months, 186 interviews were completed, and 142 (76%) reported high satisfaction with telestroke. Patients with more severe stroke were less likely to recall the consultation. Factors significantly associated with patient satisfaction were higher ratings of the technology (P<0.0001), telepresence (P<0.0001), provider communication ratings (P<0.0001), and overall Veterans Affairs satisfaction (P=0.02). In the multivariate model, telepresence (odds ratio, 3.10 [95% CI, 1.81-5.31]) and provider ratings (odds ratio, 2.37 [95% CI, 1.20-4.68]) were independently associated with satisfaction. Veterans who were satisfied were more likely to recommend the technology (P<0.0001). CONCLUSIONS: Provider qualities, including telepresence and provider ratings, were associated with overall Veteran satisfaction with the telestroke consultation. Technology quality may be necessary but not sufficient to impact patient experience. Training providers to improve telepresence could improve patient experience with telestroke consultation.
Authors: Marian P LaMonte; Mona N Bahouth; Peter Hu; Mohammed Y Pathan; Karen L Yarbrough; Ruwani Gunawardane; Patrick Crarey; Wesley Page Journal: Stroke Date: 2003-01-30 Impact factor: 7.914
Authors: Brett C Meyer; Rema Raman; Karin Ernstrom; Gilda M Tafreshi; Branko Huisa; Andrew B Stemer; Thomas M Hemmen Journal: J Stroke Cerebrovasc Dis Date: 2010-09-19 Impact factor: 2.136
Authors: Edilberto Amorim; Min-Mei Shih; Steven A Koehler; Lori L Massaro; Syed F Zaidi; Mouhammad A Jumaa; Vivek K Reddy; Maxim D Hammer; Tudor G Jovin; Lawrence R Wechsler Journal: J Stroke Cerebrovasc Dis Date: 2013-03-13 Impact factor: 2.136
Authors: Sam Wang; Sung Bae Lee; Carol Pardue; Davinder Ramsingh; Jennifer Waller; Hartmut Gross; Fenwick T Nichols; David C Hess; Robert J Adams Journal: Stroke Date: 2003-09-18 Impact factor: 7.914
Authors: Clemens Scott Kruse; Nicole Krowski; Blanca Rodriguez; Lan Tran; Jackeline Vela; Matthew Brooks Journal: BMJ Open Date: 2017-08-03 Impact factor: 2.692