Table 3.
Summary of qualitative themes describing the factors that telemedicine patients consider when selecting future visit type (n = 120 for patients with video and telephone visits)
| Meta-theme (% of total codes) | Video visits (%) | Telephone visits (%) | Sub-theme (% of meta-theme) | Video visits (%) | Telephone visits (%) | Patient experience (% of sub-theme) | Video visits (%) | Telephone visits (%) |
|---|---|---|---|---|---|---|---|---|
| Pros of Visit Type | 37 | 39 | Convenience | 61 | 52 | Elimination of commute time, associated gas and parking costs | 52 | 58 |
| Convenience for patients with limited mobility | 15 | 13 | ||||||
| Convenience for full-time employees, students, or mothers | 21 | 10 | ||||||
| Convenience due to elimination of need for access to a car or other modes of transportation | 3 | 13 | ||||||
| Convenience due to decreased or absent wait time at the physician office | 9 | 6 | ||||||
| Safety | 9 | 15 | Telemedicine is a safer option due to Coronavirus or other concerns | 100 | 100 | |||
| Humanistic Qualities | 17 | 18 | Telemedicine is family-centered by permitting multiple family members to be present at a visit | 11 | 0 | |||
| In-person visits are more personable | 89 | 100 | ||||||
| Quality of Medical Care | 13 | 15 | In-person visits provide improved communication | 71 | 67 | |||
| In-person visits provide improved quality of care | 0 | 33 | ||||||
| In-person visits are more thorough due to a longer duration of visit | 29 | 0 | ||||||
| Barriers to Telemedicine | 7 | 5 | Accessibility | 0 | 25 | Need for assistance with technology | – | 50 |
| Lack of access to a telemedicine device | – | 0 | ||||||
| Insurance does not cover telemedicine visits | – | 50 | ||||||
| System Limitations | 50 | 13 | Self-reported symptom limitations | 20 | 0 | |||
| Technology system difficulty such as WiFi/internet connection, audio/video quality issues | 80 | 100 | ||||||
| User Limitations | 50 | 63 | Difficult for children | 60 | 0 | |||
| Lack of familiarity | 20 | 60 | ||||||
| Communication difficulties due to hearing impairment | 0 | 20 | ||||||
| User technology difficulty | 20 | 20 | ||||||
| Situational Context | 40 | 39 | Stable Condition | 26 | 22 | Telemedicine is best for follow-up visits | 47 | 62 |
| Telemedicine is best for medication management | 27 | 8 | ||||||
| Telemedicine is best for non-emergent visits | 7 | 0 | ||||||
| Telemedicine is best for annual visits | 20 | 31 | ||||||
| Severe or Undiagnosed Condition | 29 | 42 | In-person visits are preferred when symptoms are worsening | 59 | 96 | |||
| In-person visits are preferred for severe or undiagnosed conditions | 12 | 4 | ||||||
| In-person visits are preferred for post-operative visits | 0 | 0 | ||||||
| Telemedicine is best for emergent situations | 0 | 0 | ||||||
| In-person visits are preferred for initial visits with a new provider | 29 | 0 | ||||||
| In-person Service Requirement | 45 | 36 | Telemedicine is best when no in-person services such as labs or imaging are required | 35 | 19 | |||
| In-person visits are preferred when in-person services are required | 4 | 5 | ||||||
| In-person visits are preferred when a physical exam is required | 54 | 76 | ||||||
| In-person visits are preferred for Botox visits | 8 | 0 | ||||||
| Inherent Beliefs | 12 | 14 | Equivalence of Telemedicine and In-person | 28 | 45 | A telemedicine physical neurological exam is equivalent to an in-person exam | 20 | 10 |
| Telemedicine permits equivalent communication to in-person visits | 0 | 10 | ||||||
| Telemedicine provides an equivalent quality of care to in-person visits | 80 | 60 | ||||||
| In-person and telemedicine visits are equally convenient due to close proximity to the clinic | 0 | 10 | ||||||
| In-person and telemedicine visits are equally safe due to COVID-19 protocols and vaccinations | 0 | 10 | ||||||
| Indifference | 72 | 50 | The utility of telemedicine depends on specific needs for the visit | 23 | 36 | |||
| Telemedicine is a suitable alternative to in-person visits during COVID-19 | 31 | 9 | ||||||
| Patients have no preference for telemedicine or in-person visits | 46 | 55 | ||||||
| Superiority of In-person Visits | 0 | 5 | Telemedicine should only be utilized as a last resort when in-person visits are not available | – | 100 | |||
| Extrinsic Variables | 3 | 2 | Awareness | 20 | 0 | Patients were unaware that telemedicine visits were an option | 100 | – |
| Alternate Decision-maker | 20 | 67 | Family member/caregiver selected the visit type for the patient | 100 | 100 | |||
| Physician or administrative secretary selected the visit type for the patient | 0 | 0 | ||||||
| Availability | 60 | 33 | Telemedicine is selected when it is the first available appointment | 100 | 100 |