Rural patient and provider perceptions of telehealth implemented during the COVID-19 pandemic

BMC Health Services Research

Research Article

Kelly A. Hirko¹  Derek Pyne²  William James²  Joshua Kroll²  David Klee³ 

[1] Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA;Munson Medical Center, Munson Healthcare, Traverse City, MI, USA;Munson Medical Center, Munson Healthcare, Traverse City, MI, USA;Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA;1400 Medical Campus Drive, 49684, Traverse City, MI, USA;

关键词: Telehealth;    Telemedicine;    COVID-19;    Rural;    Implementation;    Provider;    Barriers;   

DOI  :  10.1186/s12913-023-09994-4

 received in 2022-10-05, accepted in 2023-08-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundUnderstanding perceptions of telehealth  implementation from patients and providers can improve the utility and sustainability of these programs, particularly in under-resourced rural settings. The purpose of this study was to evaluate both patient and provider perceptions of telehealth visits in a large rural healthcare system during the COVID-19 pandemic. To promote sustainability of telehealth approaches, we also assessed whether the percentage of missed appointments differed between in-person and telehealth visits.MethodsUsing anonymous surveys, we evaluated patient preferences and satisfaction with telehealth visits from November 2020 -March 2021 and assessed perceptions of telehealth efficiency and value among rural providers from September–October 2020. We examined whether telehealth perceptions differed according to patients’ age, educational attainment, insurance status, and distance to clinical site and providers’ age and length of time practicing medicine using ANOVA test. We also examined whether the percentage of missed appointments differed between in-person and telehealth visits at a family practice clinic within the rural healthcare system from April to September 2020 using a Chi-square test.ResultsOver 73% of rural patients had favorable perceptions of telehealth visits, and satisfaction was generally higher among younger patients. Patients reported difficulty with scheduling follow-up appointments, lack of personal contact and technology challenges as common barriers. Over 80% of the 219 providers responding to the survey reported that telehealth added value to their practice, while 36.6% agreed that telehealth visits are more efficient than in-person visits. Perception of telehealth value and efficiency did not differ by provider age (p = 0.67 and p = 0.67, respectively) or time in practice (p = 0.53 and p = 0.44, respectively). Technology challenges for the patient (91.3%) and provider (45.1%) were commonly reported. The percentage of missed appointments was slightly higher for telehealth visits compared to in-person visits, but the difference was not statistically significant (8.7% vs. 8.0%; p = 0.39).ConclusionsTelehealth perceptions were generally favorable among rural patients and providers, although satisfaction was lower among older patients and providers. Our findings suggest that telehealth approaches may add value and efficiency to rural clinical practice. However, technology issues for both patients and providers and gaps in care coordination need to be addressed to promote sustainability of telehealth approaches in rural practice.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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