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December 2021; 11 (6) Research

Patient Experiences With Ambulatory Telehealth in Neurology

Results of a Mixed-Methods Study

Carly Olszewski, Sharon Thomson, Lauren Strauss, Rachel Graham, Mustapha Ezzeddine, Kristen Dodenhoff, Alexander Ambrosini, Laura Daniela Smith, Laura Silla, Allysen Schreiber, Caroline Caraci, Amy Guzik, Roy E. Strowd
First published March 12, 2021, DOI: https://doi.org/10.1212/CPJ.0000000000001072
Carly Olszewski
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Sharon Thomson
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Lauren Strauss
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Rachel Graham
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Mustapha Ezzeddine
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Kristen Dodenhoff
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Alexander Ambrosini
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Laura Daniela Smith
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Laura Silla
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Allysen Schreiber
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Caroline Caraci
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Amy Guzik
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Roy E. Strowd III
Wake Forest School of Medicine (CO, ST, KD, AA, LDS, L. Silla, AS), Wake Forest Baptist Health, Winston Salem, NC; and Department of Neurology (L. Strauss, RG, ME, CC, AG, RES), Wake Forest Baptist Health, Winston Salem, NC.
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Citation
Patient Experiences With Ambulatory Telehealth in Neurology
Results of a Mixed-Methods Study
Carly Olszewski, Sharon Thomson, Lauren Strauss, Rachel Graham, Mustapha Ezzeddine, Kristen Dodenhoff, Alexander Ambrosini, Laura Daniela Smith, Laura Silla, Allysen Schreiber, Caroline Caraci, Amy Guzik, Roy E. Strowd
Neurol Clin Pract Dec 2021, 11 (6) 484-496; DOI: 10.1212/CPJ.0000000000001072

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Abstract

Objective To assess patient experiences with rapid implementation of ambulatory telehealth during the coronavirus disease 2019 (COVID-19) pandemic.

Methods A mixed-methods study was performed to characterize the patients' experience with neurology telehealth visits during the first 8 weeks of the COVID-19 response. Consecutive patients who completed a telehealth visit were contacted by telephone. Assenting patients completed a survey quantifying satisfaction with the visit followed by a semistructured telephone interview. Qualitative data were analyzed using the principles of thematic analysis.

Results A total of 2,280 telehealth visits were performed, and 753 patients (33%) were reached for postvisit feedback. Of these, 47% of visits were by video and 53% by telephone. Satisfaction was high, with 77% of patients reporting that all needs were met, although only 51% would consider telehealth in the future. Qualitative themes were constructed, suggesting that positive patient experiences were associated not only with the elimination of commute time and associated costs but also with a positive physician interaction. Negative patient experiences were associated with the inability to complete the neurologic examination. Overall, patients tended to view telehealth as a tool that should augment, and not replace, in-person visits.

Conclusion In ambulatory telehealth, patients valued convenience, safety, and physician relationship. Barriers were observed but can be addressed.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • ↵* These authors contributed equally to this manuscript.

  • Received December 29, 2020.
  • Accepted February 28, 2021.
  • © 2021 American Academy of Neurology
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