Introduction
The SARS-CoV-2/COVID-19 pandemic interrupted delivery of outpatient healthcare. To quickly adapt to a shifting landscape and safely provide emergent and routine care, the use of telemedicine (TM) was implemented for Waisman Center (WC) clinics. As control of the COVID-19 pandemic allows for return to routine care, healthcare now must determine how TM may be integrated into care.
The WC Clinics provide diagnostic evaluation and management for genetics and developmental disabilities for residents of Wisconsin and neighboring states. Accessing genetic and developmental disabilities clinical services is challenging due to high demand and multiple barriers including those associated with long travel distances to clinic visits (e.g., travel cost and lost work and school time). We previously reported lower no show and late cancellation rates during the early months of the pandemic when WC clinics initially transitioned to TM. This report describes patient satisfaction with services received by TM in four Waisman Center clinics.
Methods
Patients seen in the Medical Genetics (MG), Biochemical Genetics (BG), Autism & Developmental Disabilities (A&DD), and the Autism Treatment Program (ATP) during the months of July and August 2020 were surveyed by telephone to assess their level of satisfaction with the visit, reason for satisfaction/dissatisfaction, whether they feel included in decisions and whether technology problems occurred. Likert scale scores and free-responses were recorded. Contact attempts and survey response were entered into a HIPAA compliant REDCap database.
Results
One hundred twenty of the 207 patients/families completed the survey (response rate of 58%). Overall, patients/families had favorable views of the care they received via TM. Ninety-three percent of respondents provided a satisfaction score of 8 or higher (a score of 10 represents the highest degree of satisfaction). The most common reasons for satisfaction with TM were related to ease of use and convenience. Patients/families indicated that a high quality of care could be delivered via TM for most appointments, and that they felt included in decisions, even though they participated via distance. Some patients experienced technology issues such as difficultly with the app or audio/visual issues, but most problems resolved themselves after the first visit. Sixty-nine percent of survey participant prefer a mix of in-person and TM visits in the future. Patients and/or families commented that some visit types were better suited to occur in person (eg, physical exam or Applied Behavioral Analysis (ABA) therapy).
Conclusion
These results represent an initial evaluation of TM and indicate TM is an effective tool for providing high quality medical genetics and developmental disabilities services. Further study will help determine the best way to integrate TM in the medical genetics and development clinic. TM has proven to be an effective way to provide health care and should maintain a role in healthcare including specialty services after the pandemic resolves.