Patient Perceptions of Telehealth Primary Care Video Visits

Rhea E. Powell, MD MPH; Jeffrey M. Henstenburg, BS; Grace Cooper, BA; Judd E. Hollander, MD; Kristin L. Rising, MD, MSHP

Disclosures

Ann Fam Med. 2017;15(3):225-229. 

In This Article

Abstract and Introduction

Abstract

Purpose Telehealth is a care delivery model that promises to increase the flexibility and reach of health services. Our objective is to describe patient experiences with video visits performed with their established primary care clinicians.

Methods We constructed semistructured, in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center. Data were analyzed with a content analysis approach.

Results: Of 32 eligible patients, 19 were successfully interviewed. All patients reported overall satisfaction with video visits, with the majority interested in continuing to use video visits as an alternative to in-person visits. The primary benefits cited were convenience and decreased costs. Some patients felt more comfortable with video visits than office visits and expressed a preference for receiving future serious news via video visit, because they could be in their own supportive environment. Primary concerns with video visits were privacy, including the potential for work colleagues to overhear conversations, and questions about the ability of the clinician to perform an adequate physical examination.

Conclusions Primary care video visits are acceptable in a variety of situations. Patients identified convenience, efficiency, communication, privacy, and comfort as domains that are potentially important to consider when assessing video visits vs in-person encounters. Future studies should explore which patients and conditions are best suited for video visits.

Introduction

Telemedicine, or telehealth, includes telecommunication via a variety of platforms designed to enhance patient-centered health care.[1–3] Telehealth in its many forms offers conveniences including increased care accessibility, decreased transportation barriers, and patient empowerment.[4–8] Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care.[9–15] One study of patient experiences with video visits in rural areas found that they were associated with decreased travel costs and lost time/wages, increased access to social support, and better ability to tailor care delivery to patient and family needs.[16]

Because of these benefits, video visits are being adopted in a variety of settings. Uptake in the United States has occurred most rapidly where reimbursement is favorable. Medicare reimburses for video visits in health professional shortage areas and for specific approved services.[17] As a result, much knowledge about patient experiences with video visits is limited to specific disease-related applications and to use in rural settings.[18–20]

Video visits are increasingly used in other settings, including primary care, but there are limited data on patient experiences with primary care video visits. One study tested video visits with patients communicating via webcam with their primary care physician while sitting in an adjacent room, followed immediately by an in-person visit. Patients reported video visits acceptable, but less satisfactory, than in-person visits.[21] While such test scenarios provide useful information about the feasibility and acceptability of video visits for primary care, understanding optimal use requires exploring real-world patient experiences.

We report results of a qualitative study of patient experiences with video visits with their established primary care clinicians and their preferences for future use of video visits.

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