Table 2.
Telemedicine Experience as Reported by Patients and Pediatric Nephrologists
| Experience | Patients | Pediatric Nephrologists |
|---|---|---|
| Perceived benefits: disease specific | 90% of patients were comfortable communicating about their health with their provider by telemedicine | |
| Perceived benefits: contextual specific | >90% of patients were able to save time traveling to the hospital/clinic for appointments (n = 400); most patients reported that virtual visits were better in terms of travel time to clinic (85%), finding convenient time for their visit (71%), and amount of time waiting for the clinician (53%) | Physicians (n = 321) reported 25% better, 42% similar, and 33% worse telemedicine visit attendance compared with in-person visits by patients |
| Perceived benefits: consultation specific | >90% thought that their provider was able to understand their health condition, received adequate attention, and the care provided via telemedicine was consistent with the in-person visits (n = 400) | |
| User satisfaction | Patient satisfaction (n = 400) with quality of the telemedicine experience was similarly positive to their in-person visits (87%); a subset of patients (n = 250) provided scores in the Healthgrades system, and their satisfaction level was similar during the COVID-19 pandemic (mean score, 4.2-4.6 of 5) with telemedicine visits in comparison to 2019 ratings (mean, 4.2-4.8 of 5)15; in the Healthgrades ratings, patients had overwhelmingly positive reviews of their telemedicine visits: 67% gave score of 9-10 of 10; 24%, 7-8; only 9%, <6 | Physicians reported being very satisfied/satisfied (14%/57%) or neutral (25%) |
| User dissatisfaction | Patients (n = 400) reported that the ability to have a physical examination (80%) and overall quality of visit (60%) was better with office visits | (n = 13) 4% were dissatisfied with telemedicine overall |
| Challenges | Patients (n = 400) reported that personal connection with clinician was better with in-person setting in 60% of cases; not comfortable sharing confidential information in 30% of cases; patients (n = 400) reported inability to show clinician a physical problem 80% of times; the cost of the visit was better for the in-person clinic visits 33% of time | Physicians (n = 321) reported technology-related challenges (36%) followed by inability to perform physical examinations (30%) or laboratory tests (18%), unfamiliarity with telemedicine (9%), and being uninformed about billing (7%); the 321 responders stated that telemedicine services were not connected to the electronic health record in 60% of cases, had no waiting room feature to queue in patients in 32% of cases, and had restrictions in performing telemedicine services in 24% of cases |
| Cost | 65% of patients were definitely willing to co-pay $10-$25; 28% were definitely willing to pay $26-$50; and 18% were definitely willing to pay full cost of televisit | Inability to use billing codes for telemedicine in 9% of cases |
| Suggestions for improvement | Changes in cost to patient to make it more affordable? | Physicians (n = 321) suggested that better equipment (39%) followed by pre-check of patients (25%) and increased training (25%) would improve the experience; ∼12% did not suggest changes |
Abbreviation: COVID-19, coronavirus disease 2019.